Amarante Paulo, Nunes Mônica de Oliveira
Laboratório de Estudos e Pesquisas em Saúde Mental e Atenção Psicossocial, Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Universidade Federal da Bahia, Instituto de Saúde Coletiva. Salvador BA Brasil.
Cien Saude Colet. 2018 Jun;23(6):2067-2074. doi: 10.1590/1413-81232018236.07082018.
T This article presents a historical and epistemological study of the construction of public policies about mental health and psychosocial care in Brazil´s Unified Health System, the SUS. To that end, it proposes an approach that identifies actions and strategies related to social participation in the construction of policies, one of the founding principles of SUS, seeking to delineate its importance in the specific trajectory of the psychiatric reform process. Subsequently, it highlights the originality and importance of actions that used culture as a means and as an end, in the sense of not restricting psychiatric reform to a transformation limited to public services or health in the strict sense of the term, emphasizing the principle of construction of a new locus in society for madness. Finally, it provides a historical follow-up of the promulgation of mental health policies in Brazil, identifying the most important initiatives and their impacts on the transformation of the care model, and concludes by questioning the conservative restructuring that is currently taking place.
本文对巴西统一卫生系统(SUS)中关于精神卫生和心理社会护理的公共政策构建进行了历史和认识论研究。为此,它提出了一种方法,该方法确定了与社会参与政策构建相关的行动和策略,社会参与是SUS的基本原则之一,旨在阐明其在精神科改革进程特定轨迹中的重要性。随后,它强调了将文化既作为手段又作为目的的行动的独特性和重要性,即不将精神科改革局限于严格意义上的公共服务或健康方面的转变,强调在社会中为精神错乱构建一个新场所的原则。最后,它对巴西精神卫生政策的颁布进行了历史追踪,确定了最重要的举措及其对护理模式转变的影响,并通过对当前正在进行的保守重组提出质疑得出结论。