“Navegar é preciso” - cartografando subjetividades em saúde mental.

Abstract

This work analyses from a mapping prospective the mental health field, the subjectivity, and the cultural influences found throughout the centuries, that involve and define the universe of madness. It also discusses the consequences of labeling, and the insertion of madness among the diseases classification, thus justifying the intervention over the liberty and the right to take care of themselves of those classified as mad, exercising the so-called Psychiatric Authority / Psychiatric Power. Cartography helped us with this task, as a tool borrowed from Geography, where is used in order to map territories and populations, but here we are looking for mapping the social relationships, and their characteristics in the health care processes. The research was conducted at CAPS Geral II, in the city of Sobral, State of Ceara, Brazil, where mental health professionals as well as patients answered a semi-structured interview. It also tells about the Psychiatric Reform, how it was conducted in Brazil, and in the city of Sobral, provoking the surge of new practices of care in mental health. Those processes of change in the ways of dealing with mental health patients led to a transformation not only in the processes of care, but also in a behavioral change, and in the way professionals see the mental illness, which resulted in a deep change of the healthcare system, towards those mentally ill. It also called the attention to the questions about their humanity and their individuality within society. Some questions started to appear, related to the way that CAPS Geral of Sobral takes care of their users: how the professionals conduct the therapeutic activities? Which kind of difficulties happen in a daily basis? In which way could they work to improve patients’ confidence and autonomy? How the creativity could be exercised within the working processes of the mental health professionals, as well within patients’ therapeutic activities? In search for the answers, we understood that the biological and physician-centered approach is still strong, and that there are many barriers to developing or practicing an interdisciplinary teamwork. We also found that the working contracts are precarious, having a negative effect on all, workers and users of the services; we also found, however, that dedicated professionals use their creativity every day in order to provide the users with various activities, attempting to rescue and fortify the individuality and autonomy of the users.