Entre a igualdade e a diferença: reflexões sobre os conceitos de cidadania e sujeito nos centros de atenção psicossocial de Sobral

Abstract

In the period between the 1960s and 1980s, the Brazilian Psychiatric Reform Movement promoted the transition from a manicomial model to a model of Psychosocial Care based on citizenship, creating and expanding alternative and community services, such as the Psychosocial Care Centers. In Ceará, the implementation of these services began in the 1990s and in Sobral only in 1999s with the Integral Mental Care Network. Psychoanalysts have contributed in the public institutions of mental health pointing to the dimension of the unconscious and the listening of what is singular in subject. This paper seeks to understand which discourses and practices about the conceptions of citizenship and subject in psychoanalysis pointed out in the literature and their practical and political implications within the scope of the current National Policy of Psychosocial Attention. This is a research oriented by psychoanalysis, from the reading of texts on Brazilian Psychiatric Reform and psychoanalytic writings that have carried out an articulated work in the field of mental health. The capture of the citizenship category as an ideal sought by the Brazilian Psychiatric Reform and the guiding axis of psychosocial services produces obliterations in the place occupied by the clinic in Psychosocial Attention. The inclusion of all individuals by the State from the egalitarian quality of citizenship does not support the effects of the unconscious. We understand that the practices instituted by the Brazilian Psychiatric Reform are important for guaranteeing access to social rights, but do not necessarily dialogue with the demand of each subject for whom this discourse is directed. We point out that work guided by citizenship and psychoanalysis are distinct dimensions of care for madness, but that they do not oppose, and it is necessary to rescue what is singular in the one by one.