Por uma de(s)colonização da saúde mental: vozes negras na produção do campo da atenção psicossocial do Ceará

Abstract

The problem of colonialism, racism, and epistemicide, which produce effects on the mental health of the black population, expressed in different power devices, also acts in the erasing/silencing of the ethnic-racial and colonial debate in the proposal of the Brazilian Psychiatric Reform. Faced with these challenges, which have been expressed in institutional practices in the field of psychosocial care, the problem of this thesis can be explained by the following research question: What displacements to the field of mental health and psychosocial care can be experienced from the way black voices guide the care of the black population in scientific literature and the RAPS of Ceará? To answer the problem of this research, its overall objective was to analyze challenges and possibilities for a de(s)colonization of the field of mental health and psychosocial care, from the dialogue with black voices who work in the RAPS in the context of the State of Ceará. The proposed analytical exercise consisted in making visible the political contributions of black voices, because, by denouncing racism, colonialism, and its intersection with other violence, the study focuses on repairing the extermination of existences, powers, and collection agencies of black people in the world. The discussion establishes articulations of Psychology with studies on race, racism, whiteness, mental health, psychosocial care, counter-colonial studies, and their relations with the processes of subjectivation, bringing Afrodiasporic epistemologies of the mental health field historically erased in health training. As the main results, by problematizing, through a systematic review of literature, how the Brazilian scientific production has guided the relationship between racism and mental health, it highlights the little emphasis on Afrocentered and counter-colonial epistemologies to guide the processes of health-disease-care of black people. From the dialogue with black professionals inserted in the RAPS and from the antiracist and anticolonial epistemologies, the challenges for the BPS and the anti-asylum movement in Brazil consist in considering the social markers of difference as social determinants in health; the strengthening of social participation of black and/or quilombola and/or indigenous populations, reconstruction and radicalization of the idea of madness within an afro centered and anticolonial perspective. From the trajectories of black professionals in RAPS, we signal that one of the effects of racism and its intersectionalities in mental health conditions and practices in psychosocial care is the abstraction of madness, disregarding the dimensions of race, ethnicity, gender, territory, and generation. In addition, suffering has been understood as detached from the socio-political dimension, disregarding black experiences in contexts of illness. By pointing paths for the production of anti-colonial and anti-racist care practices in psychosocial care, the thesis supports the construction of a care policy that dialogues with the voices of users and workers; guaranteeing, in its framework of caregivers, black representation, with the promotion of affirmative action; localized and territorial practices to overcome the violence that crosses daily life and invention of new grammars and images in the production of psychosocial care.