Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-04-22T21:37:27Z No. of bitstreams: 1 MauraLimaBezerraESilva_TESE.pdf: 1883523 bytes, checksum: fa88fa571b61559f5b569d7ccebc9c5a (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-04-22T21:50:51Z (GMT) No. of bitstreams: 1 MauraLimaBezerraESilva_TESE.pdf: 1883523 bytes, checksum: fa88fa571b61559f5b569d7ccebc9c5a (MD5) / Made available in DSpace on 2016-04-22T21:50:51Z (GMT). No. of bitstreams: 1 MauraLimaBezerraESilva_TESE.pdf: 1883523 bytes, checksum: fa88fa571b61559f5b569d7ccebc9c5a (MD5) Previous issue date: 2015-06-12 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A Pol?tica Nacional de Sa?de Mental se caracteriza como uma pol?tica territorial-comunit?ria e tem a Estrat?gia Aten??o Psicossocial (Eaps) como norteadora para a proposi??o e o desenvolvimento de suas a??es. Em seu desenho, o CAPS ? um equipamento estrat?gico dentro da Rede de Aten??o Psicossocial/RAPS. O apoio matricial e a aten??o ? crise configuram frentes estrat?gicas de a??o dos CAPS em sua miss?o substitutiva e, guiados pela b?ssola da desinstitucionaliza??o, s?o essenciais para o ?xito desses servi?os. Defendemos que sustentar crises nos territ?rios existenciais de vida ? uma condi??o para a efetiva??o da Aten??o Psicossocial e, no limite, para a sustentabilidade da pr?pria Reforma. Nesta dire??o, a ferramenta do apoio matricial se revela uma apoiadora territorial, intercessora e potente na constru??o de uma Aten??o Psicossocial ? crise. Reconhecidos como grandes desafios pelo Minist?rio da Sa?de, avan?ar estas frentes se materializa para os trabalhadores em seus of?cios micropol?ticos. A nossa pesquisa se coloca como um investimento na dire??o de potencializ?-las e teve como objetivo conhecer a operacionaliza??o da aten??o ? crise e do apoio matricial em um CAPS II, na perspectiva dos seus trabalhadores, bem como analisar tais pr?ticas frente aos princ?pios e prop?sitos da Estrat?gia Aten??o Psicossocial. Inspirados na pesquisa-interven??o e no ide?rio pol?tico-social da An?lise Institucional, ofertamos um espa?o de reflex?o e troca, atrav?s de entrevistas de implica??o, possibilitando que os trabalhadores se lan?assem em an?lise das pr?ticas na perspectiva da Eaps. Fizemos consulta documental ao Projeto T?cnico do CAPS e uma etapa de restitui??o, organizada em formato de oficina e rodas de conversa. L?gicas institucionais competem no Servi?o. Operando pela l?gica do risco, dificuldades em sustentar situa??es de crises mais intensas foram identificadas, de modo que o hospital psiqui?trico termina sendo utilizado como um recurso de interna??o, principalmente diante de casos em que o elemento da agressividade se faz contundente, e quando os suportes do SAMU, dos CAPS III e dos Leitos de Aten??o Integral n?o respondem a contento. Indicam-se fragilidades de ordem macro e micro interferindo no suporte da rede. As a??es do matriciamento, mesmo identificadas como um potente recurso intercessor no cuidado ? crise, apareceram enfraquecidas, apontando pouca porosidade na rela??o Servi?o com o territ?rio. Marcadas pela l?gica do atendimento domiciliar, sem operar prioritariamente como dispositivo de troca de saberes, v?-se pontos de captura na l?gica da assist?ncia, com produ??o de ambulatoriza??o do CAPS, pr?ticas assistencialistas e de ?apaga-fogo?. Efeitos das a??es de cuidado nos usu?rios s?o identificados pelos trabalhadores sem as repercuss?es desejadas no horizonte de expans?o da vida e a Eaps, ainda que desponte como um norteador, n?o ? vista como pr?tica efetivada. Apesar de os resultados sinalizarem que a aten??o ? crise e as a??es do matriciamento s?o desenvolvidas sem conex?o tenaz com os prop?sitos da Eaps, casos exitosos s?o indicados tendo como principais fios condutores a tessitura micropol?tica da intersetorialidade das a??es, dos v?nculos potentes e da participa??o do usu?rio em seu processo de cuidado, indicando for?as insurgentes que tencionam por deslocamentos de l?gicas tradicionais. / The National Policy on Mental Health is characterized as a territorial - political community , and it has the Psychoso cial Care Strategy (Eaps) as guideline for the proposal and the development of their actions. In its design, CAPS is idealized to be a strategic equipment within the Psychoso cial Care Network/RAPS. Matricial support and at tention to the crisis constitute strategic areas of action of CAPS in its replacement mission , and as it is g uided by the scope of deinstitutionalization, those are essential to the success of these services. We argue that sustain crises in existential territories of life is a condition for the effectiveness of psychosocial care and, ultimately, to the sustainability of its Reform. In this direction, the matricial support tool reveals a territorial supporter, intercessory and powerful in building a psychosocial care to the crisis. Recognized as one of the major challenges by the Brazilian Ministry of Health, forward these fronts materializes for workers in their mi cropolitical crafts. Our research arises as an investment toward empower them , and aimed to understand the operationalization of attention to the crisis and matricial support in a CAPS II, in the view of its workers . Besides, it aims to examine such practi ces forward the principles and purposes of Psychosocial Care Strategy. Inspired by the research - intervention and by the political and social ideas of Institutiona l Analysis, we offer a space for reflection and exchange, by implicational interviews , enablin g workers to launch them in analysis of practices in the EAPs view. We have done a documentary consulting CAPS Technical Project, and a return stage to the institution, by organizing workshop and conversation groups with CAPS workers. The results have show n that there are institutional logics in competition on that service. When operating the logic risk, some difficulties in sustaining most intense crisis situations were identified, the psychiatric hospital internment is used as a facility, particularly in view of some cases, in which the aggressiveness of the person in crises becomes aggressive, and when the brackets SAMU, the CAPS III and Comprehensive Care Beds do not respond satisfactorily to their users requests. Order weaknesses were indicated in this thesis as macropolitical and micropolitical interfering in network support. The matricial actions were identified as a powerful intercessor resource in crisis care appeared weakened, and indicates little porosity in the relationship between the Service and the territory where it takes place. Noticed by the logic of home care, without operate primarily as a knowledge exchange device, we saw capture points in the logic of assistance with ambulatoriza tion production of CAPS, welfare practices and "ext empore " . T he E APs , although it emerge s as a guiding, it is not seen to workers as effective practice. On the one hand, the results signaled that the attention to the crisis and the matricial actions are developed without tenacious connection with the purposes of EA Ps, on the other hand, successful cases were indicated with the main leads to conducting wire of intersectoral actions to the powerful bonds and to the participation of user in their care process es , indicating insurgent forces tha t intend by traditional lo gic .