Admissão e envolvimento terapêutico em saúde mental: mão ou contramão de um mesmo processo?

Abstract

Autonomy and crazy, historically, never walked side by side, let alone in a synchronized way. Means for autonomy, the ability of an individual to decide freely about their own actions and therefore delineate their life trajectory. Reflecting on the concepts of autonomy, crisis and demand, how the bearer of psychological distress is admitted, it expresses a demand or others? Even in crisis, it would be possible to express a demand linked to their subjectivity and social interactions. If the user does not reach the service unattended, the therapeutic project can relate to a demand that does not concern bearer of psychological distress? The aim of the study was to know the mode of admission and membership of the users in a therapeutic project Reference Center for Mental Health (CERSAM) in the city of Belo Horizonte - Minas Gerais. This is a case study, qualitative approach performed at a Center of Mental Health Reference. We selected 3 reference therapists and 8 service users to participate in the study, mediants inclusion and exclusion criteria previously established. Interviews were conducted with semi-structured participants, as well as non-participant observation of the dynamics of the service. We used content analysis proposed by Bardin, such as technical analysis, resulting in six categories and ten sub-categories. The study was approved by the COEP of the Municipal Health Department and the Federal University of Minas Gerais. All participants signed an informed consent form. Participants indicate a link between the mode of admission and therapeutic involvement, since negative experiences when admission can be transferred to the service and the proposed treatment. Users indicated that spontaneous sets up the best mode of entry into the service, instead of forwarding by police car or emergency department due to unpreparedness of these professionals in dealing with mental health. The technical reference underscore the relevance in addressing the subjectivity of the user during the crisis in order to conduct a proper clinical management on admission, that reduces the interference in therapeutic involvement.