O acompanhamento terapêutico como potente estratégia de cuidado nas clínicas da desinstitucionalização

Abstract

This research aims to have a theoretical and conceptual argument on the notion of Clinics of Deinstitutionalization and discusses the strategies that may be achieved through the new means of conceiving and practicing clinics in mental health nowadays, in special for what I have experienced during my travelings on . In a course that begins with the history and the practical training of the Therapeutic Accompaniment (AT) it may be inferred that this clinical variable brings on the opening of new space to work with people in mental distress surpassing the idea that interventions must happen in closed settings. Intertwined with postulates of other clinics which search for transcending the medical -centered standard, a hibrid and itinerant composition of a collective of professionals that may favour new ways of monitoring treatments is thought here as becoming-nomad. One does not intend the role of these professionals to be that of sticking up to protocols or truths previously indicated, but of enlarging its field of performance in the area and including in this complex network the effective participation of the population on a common management of actions in mental healthand mainly, concerning the exercise of a full citizenship. For accomplishing this research, a conceptual exhibition of AT practice, of themes and reflections about the conception of deterritorialization, rhizome and cartography was made. Regarding mental health clinics, plots and indications of its ways of performance, frame and incidence were pointed, as well as an exhibition of the process of deinstitutionalization from the origin to the inclusion of this type of reform in the ambit of assistance in mental health in Brazil. Composing the research, journals of field experiments performed by the researcher in distinct contexts that happened in Barcelona, Spain and Trieste, Italy are incorporated. In these cities were observed and subsequently transformed in material for the research in screen, associativist movements and also professionals, users and families which may be called deinstitutionalists - because they are tuned with the practices and proposals of Clinics of Deinstitutionalization studied here - were observed and subsequently transformed in material for the research in screen. These are practices that seek the protagonism of their actors and the involvement of several sections of society for a final objective, common to all the groups studied, which is the one of living a full, democratic citizenship and preserving civil rights of people even if they are in a situation of social disadvantage. The research reveals several facets of these autonomist practices and of Deinstitutionalization Clinics capable of operating in transforming the society and giving a more qualified and complete assistance to the ones who need this support. To these practices, we infer that the Therapeutic Accompaniment may be an important strategy for an accomplishment of this clinic intention strictly linked to the social matter.