Este trabalho traz algumas considerações e problematizações das políticas sobre drogas, transcorrendo pela história da Redução de Danos em seu percurso clínicopolítico desde o campo da AIDS e sua transição como diretriz de trabalho para o cuidado a pessoas que usam álcool e outras drogas no campo da saúde mental. Para isso, utilizamo-nos do Método da Roda, que serviu também para pensar o papel do apoiador institucional e a cogestão de coletivos, para nos aproximamos de um município em que foi possível acompanhar os modos de andar a redução de danos também no campo micropolítico e, assim, pensar nessa transição e nas perspectivas de trabalho para a atenção básica. Com isso, apresentamos a Redução de Danos como tecnologia leve de cuidado, que circula pelo território e acompanha os diferentes modos de andar a vida, que está atravessada pelos impasses da Reforma Psiquiátrica e pela precarização do trabalho, que acompanha o trabalho da redução de danos desde o seu início e que se atualiza neste campo de pesquisa. / This essay brings some consideration and render problematily of the politics about drugs, elapsing between harm reduction in its political clinical course since Aids field and its transition as guideline of working to care to people that use alcohol and other drugs in the mental health field. For this, we use the wheel method, that fit also to think about the institucional supportes role and the co-management of collective to approach to a county that was possible to follow the way of the harm damage goes and also in the micropolitical field and, so, think about this transition and in the work perspectives to the basic attention. Therewith, we show the harm reduction as light care technology, that moves within the territory and follows the different ways of livong life, that is crossed by impasses of the psychiatric reform and by Precariously of the work, that follows the harm reduction work since its updates in this research field.

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-06-28T18:52:41Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Polyana Felipe - Mestrado em Saúde Coletiva (PPGISC).pdf: 54230265 bytes, checksum: 42616aa26e49ad7e2dc0904afeaf5628 (MD5) / Made available in DSpace on 2016-06-28T18:52:41Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação Polyana Felipe - Mestrado em Saúde Coletiva (PPGISC).pdf: 54230265 bytes, checksum: 42616aa26e49ad7e2dc0904afeaf5628 (MD5) Previous issue date: 2015-04-06 / CAPES / O agronegócio canavieiro no Brasil vem se destacando no cenário econômico nacional e internacional como um modelo de desenvolvimento gerador de energia limpa e renovável. Entretanto, o seu desenvolvimento é contraditório. Pois, ao mesmo tempo em que permite a introdução de novas tecnologias, escamoteia condições e relações de trabalho precárias, bem como a destruição ambiental. A proposta desta dissertação é desvelar os mitos construídos em torno do “desenvolvimento” do agronegócio canavieiro, bem como os reflexos da mecanização na saúde mental dos trabalhadores-migrantes. Foi realizada uma análise criteriosa da literatura, aplicação do questionário Self-Reporting Questionnaire (SRQ-20), observação participante e entrevistas semi-estruturadas com trabalhadores-migrantes do sertão paraibano e pernambucano que laboram na colheita manual da cana-de-açúcar, na Usina Santa Isabel, localizada na região de São José do Rio Preto, interior do Estado de São Paulo. Os resultados mostram a (in) sustentabilidade do agronegócio canavieiro, uma vez que tal produção é fortemente marcada por condições perversas de degradação ambiental e descaso com a vida humana. Constatou-se também a alta prevalência (40%) de Transtornos Mentais Comuns e sua associação com o baixo nível de escolaridade dos trabalhadores-migrantes, a positividade do teste CAGE indicando casos suspeitos de bebedores-problemas, o adoecimento relacionado ao trabalho e o absenteísmo. Por outro lado, o sofrimento psíquico ficou evidente no relato dos trabalhadores que denunciam novos padrões de riscos, divisão do espaço de trabalho com moderníssimos maquinários e rigorosos mecanismos de controle, como as punições, advertências e demissões que amedrontam e ameaçam o futuro destes trabalhadores. Por fim, acredita-se que o desafio essencial passa pela construção de políticas públicas inovadoras para o meio rural nordestino; políticas que dêem acesso ao trabalho, renda, educação e outros serviços básicos, inclusive, já garantidos na legislação brasileira. / The sugarcane agribusiness in Brazil has been increasing in national and international economic scenery as a generator model of development of clean and renewable energy. However, its development is contradictory. Because at the same time allowing the introduction of new technologies, sidesteps conditions and poor working relations and environmental destruction. The purpose of this work is to unveil the myths built around the "development" of the sugarcane agribusiness, as well as the reflections of mechanization in the mental health of workers-migrants. A careful review of the literature was carried out, the questionnaire Self-Reporting Questionnaire (SRQ-20), participant observation and semistructured interviews with backwoods of workers-migrants Paraiba and Pernambuco that operate on manual harvesting of sugarcane in Usina Santa Isabel, located in the region of São José do Rio Preto, in the state of São Paulo. The results show the (un) sustainability of the sugarcane agribusiness, since this production is strongly marked by perverse conditions of environmental degradation and disregard for human life. It was also found a high prevalence (40%) of Common Mental Disorders and its association with the low educational level of workers-migrants, test positive CAGE indicating suspected cases of drinkers problems, workrelated illness and absenteeism. On the other hand, the psychological distress was evident in the story of workers who report new standards risks, division of work space with ultramodern machinery and strict control mechanisms, as punishment, warnings and layoffs that frighten and threaten the future of these workers. Finally, it is believed that the essential challenge is to build innovative public policies for the northeastern countryside; policies that give access to work, income, education and other basic services, including, as guaranteed by Brazilian law.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Esta dissertaÃÃo objetivou analisar os sentidos construÃdos sobre saÃde-doenÃa mental por participantes de um grupo terapÃutico do CAPS e suas implicaÃÃes ao processo de desinstitucionalizaÃÃo da loucura. Para tanto, esteve referenciada nos aportes da SaÃde Coletiva, no tocante a produÃÃo social do processo saÃde-doenÃa e ainda nas contribuiÃÃes teÃricas do campo da SaÃde Mental sobre a proposta de desinstitucionalizaÃÃo da loucura no cotidiano das prÃticas de cuidado e atenÃÃo aos usuÃrios. AlÃm dessas bases, o estudo conta tambÃm com o referencial da Teoria HistÃrico-Cultural da Mente, no que se refere Ãs suas elaboraÃÃes em torno da temÃtica dos sentidos. Metodologicamente, a pesquisa se configurou como uma investigaÃÃo de carÃter qualitativo. A pesquisa foi realizado no CAPS Geral da SER II de Fortaleza, por meio do contato com um dos grupos terapÃuticos dessa instituiÃÃo, o Grupo de Florescimento Humano. O contato com esse grupo iniciou-se em julho de 2010, primeiramente, por meio da metodologia da ObservaÃÃo Participante, com intuito de conhecer o modo de funcionamento dessa proposta terapÃutica. Posteriormente, foi realizada uma Entrevista Individual Semi-Estruturada com uma das participantes. Por fim, foi aplicado um questionÃrio escrito com doze pessoas do grupo, as quais tambÃm participaram de um CÃrculo de Cultura sobre o tema desta pesquisa. O material oriundo desses procedimentos foi registrado com o auxÃlio de um gravador de voz, em seguida, foi transcrito e analisado com base na metodologia da AnÃlise TemÃtica. Como resultado de tal proposta de anÃlise, foram categorizados trÃs temas que mais se destacaram do discurso dos participantes, quais sejam: a conceituaÃÃo da loucura e do processo saÃde-doenÃa mental; as histÃrias e âestÃriasâ que explicam as existÃncias-sofrimento e a produÃÃo da saÃde mental; a construÃÃo de sentidos e desinstitucionalizaÃÃo. Os achados desta pesquisa apontam que a loucura e o processo saÃde-doenÃa mental encontram-se imersos em um quadro de grande indefiniÃÃo cientÃfica, que gera muitas possibilidades de significaÃÃes em torno da questÃo. Os sentidos de saÃde e doenÃa mental produzidos com os participantes circularam em torno de adjetivos antagÃnicos que indicaram a presenÃa marcante de uma noÃÃo de saÃde mental como algo inalcanÃÃvel, por significar a ausÃncia de doenÃas. JÃ a doenÃa mental foi percebida como desajuste, erro, desequilÃbrio e acÃmulo de problemas. Por outro lado, os participantes tambÃm destacaram a existÃncia de diferentes modos de ser e existir no mundo como marcas de singularidades, que, frequentemente sÃo diagnosticadas como loucura. Eles apontaram apara a necessidade de convivÃncia com essas diferenÃas e com seu processo de sofrimento. Como mais um resultado do estudo, foi discutida a importÃncia da categoria sentido, como ferramenta essencial a ser valorizada e trabalhada na proposta de desinstitucionalizaÃÃo da loucura no cotidiano dos serviÃos de saÃde mental. / This paper aimed to analyze the constructed meanings of health-mental illness participating in a therapeutic group of CAPS and its implications to the process of institutionalization of madness. To do so, was referenced in the contributions of Public Health, regarding the social production of health-disease process and also on the theoretical contributions of the field of Mental Health on the proposal of de-institutionalization of madness in the daily practice of care and attention to users. In addition to these bases, the study also has the frame of the Cultural-Historical Theory of Mind, with regard to their elaborations around the theme of the senses. Methodologically, the research was configured as a qualitative research. The study was conducted at the General CAPS II, Fortaleza-Ce, through contact with an institution of the therapy groups, the group of human flourishing. Contact with this group began in July 2010, primarily through the methodology of participant observation, in order to understand the mode of operation of the proposed therapy. Subsequently, we performed an Individual Semi-Structured Interview with one of the participants. Finally, a questionnaire was written in twelve people in the group, which also participated in a Culture Circle on the subject of this research. Material from these methodologies was recorded by audio-recorded, transcribed and analyzed using thematic analysis. As a result of this proposed analysis, three themes were categorized that stood out the speech of the participants, namely: the concept of madness and mental health-disease process, the stories and "stories" that explain the stock-suffering and production mental health, the construction of meanings and deinstitutionalization. The findings of this survey indicate that the madness and the health-mental illness find themselves immersed in a framework of great scientific uncertainty, which generates many possible meanings around the issue. The meanings of health and mental illness produced with participants circulated around opposing adjectives that indicated the presence of a remarkable notion of mental health as something unattainable, because it signifies the absence of disease. Since mental illness was perceived as a misfit, error, imbalance and accumulation of problems. On the other hand, participants also highlighted the existence of different modes of being and existence in the world as marks of singularities, which are often diagnosed as insane. They pointed out the need to trim live with these differences and their grieving process. As a result of the study, it is pointed towards the category as an essential tool to be valued and worked in the proposed institutionalization of madness in everyday mental health services.

Na atualidade, entende-se que o campo do conhecimento da saúde mental é amplamente complexo e intersetorial, abrangendo muitos saberes. Muitos estudos sobre os cuidadores do sujeito com transtorno mental no Brasil, que revelam que apesar da mudança do paradigma no tratamento psiquiátrico - ocorrida na segunda metade do século XX - ainda há violações dos direitos dos pacientes internados, além do sentimento, na equipe de atenção, de certo desamparo e falta de conhecimento sobre o lidar com o paciente. Este trabalho teve como objetivo buscar conhecera visão de auxiliares de enfermagem de um setor de agudos masculino e feminino de um hospital especializado em psiquiatria do interior do estado de são paulo a respeito de seu trabalho. mais especificamente, pretende-se conhecer, a partir de sua própria perspectiva, a trajetória e formação profissional dessas pessoas, o contexto institucional e as práticas cotidianas envolvidas em seu trabalho e suas concepções a respeito da clientela atendida. Foram entrevistados através da \"história de vida temática\" onze auxiliares de enfermagem. Essas entrevistas foram gravadas e transcritas na íntegra, e analisadas qualitativamente. A análise permitiu apontar os seguintes temas: suas trajetórias de vida, influências recíprocas entre a vida pessoal e do trabalho, a formação dos profissionais,o perfil do auxiliar, a rotina de trabalho e seus apoios a visão sobre o paciente psiquiátrico, sua família. Os relatos convergiram para a apresentação da maneira como se configura o trabalho do auxiliar de enfermagem, quanto às suas visões e condições para o trabalho cotidiano Considera-se que é importante promover a criação de espaços de reflexão, discussão e escuta entre os profissionais de saúde mental, dentro dos setting de trabalho, integrando principalmente os que lidam diretamente com o paciente, de modo que nesses espaços se possa conversar sobre questões da prática diária específicas, mas também transcender a elas; relacionando essa prática com repercussões da vida pessoal no trabalho, promovendo apoio ao trabalhador. / It\'s well known that the mental health knowledge field is complex and inter sectorial. Many studies about the mental health patient, in Brazil, have revealed that although there was a change in the psychiatric treatment, still there is patients rights violations, and the feeling in the attention group is of certain hopelessness and lack of knowledge in dealing with the patient. This work aims to explore a masculine and feminine acute unit nursing personnel, in a psychiatry specialized hospital in the inner State of São Paulo, from the point of view of their work. More specifically, it\'s intended to know, from their own perspective their professional pathways and education, the institutional context and their everyday practices concerning work and clients. Eleven nursing professionals were interviewed through \"thematic life history\" interview. Those interviews were taped and integrally transcript and analyzed qualitatively. The analysis showed their life pathways, influences of their personal lives on work, professional education, work routine, support on psychiatric patients and the patient\'s family concepts. It\'s considered that it\'s important to promote reflection, discussion and hearing spaces among mental health professionals, in the work setting, with those who deal directly with the patient and the whole team so it\'s possible to discuss on every day practices, transcend to them relating to personal life repercussions, promoting support for work.

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Homelessness in the youth population is associated with elevated rates of mental illness, substance abuse, and suicidality compared to the housed population in the United States (Berdahl, Hoyt, and Whitbeck, 2005; Hodgson, Shelton, Van den Bree, 2014; Hughes et al., 2010). With a survival-focused perspective, exacerbating issues, stigmatization, and transience housing; homeless youth require special consideration to meet their diverse health needs. When barriers impede homeless youth's access to necessary health resources, their health concerns are left untreated and impound until emergency services are required. This review of literature is focused on identifying and synthesizing barriers and facilitators for homeless youth to access and utilize mental health care services. When untreated mental illness reaches a crisis point, it becomes more expensive to treat (Taylor, Stuttaford, and Vostanis, 2006). For youth experiencing homelessness, various factors influence their decisions to wait until a crisis to reach out to emergency services. Within the literature, barriers and facilitators were bracketed into personal, social, and structural factors. These factors ranged from financial concerns, communication with health care providers and between health care service locations, stigmatization, lack of awareness, and administrative requirements. While further research is required, evidence from the literature shows promise in developing and altering interventions and communication to meet homeless youth's mental health and substance abuse needs.

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The thesis looks firstly at creativity and the creative process, approaching the subject from a whole range of different viewpoints, such as the psychological, philosophical, biographical and anthropological angles. Following from this there is an exploration of the ways in which creativity way be awakened and unfolded. Special attention is given to the conditions and situations that are likely to encourage creative development and to the blocks and difficulties that inhibit its expression. Particular reference is made, on the one hand, to art education and to the art, leisure, and teaching student, and on the other hand, to art therapy and the psychiatric patient. The themes of the individual and the community are explored in a complementary way in the final two chapters. The thesis emphasizes the viewpoint of the student and the patient, but since these people do not exist in a vacuum, this involves looking also at the teacher, the therapist and society. With reference to the psychiatric field, other specific questions arise, for example: How may creative opportunities assist the healing process? What are the reciprocal influences of art and mental illness? Throughout the thesis the term 'art' is used in the visual sense, but references are made to creativity in other fields where parallel conclusions apply. The emphasis has been placed on the adult, but the subject of 'Creativity and the Teaching Student' involves some references to child art and 'Creativity and the Community' involves all ages.

The purpose of this study was to investigate the self- rated mental health of social services clients and see what affects it. A comparison was made against the other respondents regarding mental health. The study investigated the link between mental health and some different variables, such as gender, country of origin and whether they have emplyment or not. In addition, it was also examined how clients experienced the meeting with the social services and whether there was connection between their mental health and contact with social services. The material that formed the basis for the study was PART-studien (Mental health-Employment-Relations) and was collected by three researchers; Forsell and Lavebratt from Karolinska Institutet (KI) and Lundberg of Uppsala University, and concerned individuals' living conditions and mental health. To analyze the use Goffman's theory (2011) of psychological and social stigma and Ahmed Anis theory analysis on stigma and its three levels of stigma; social stigma, self-stigma and professionals stigma against clients. Previous research in this field has also helped in the interpretation of the results, as previous research reinforced the image of the individual's self- rated mental health varies between different groups in society, and that mental illness is linked to stigma. The result shows that self- rated mental health was adversely affected if they were a client of social services, if they were a woman, if they were born abroad, if they dint´t had employment and if they had a negative experience of the encounter with the social services. It also revealed that those who were in contact with social service felt worst in general, regardless of the other variables influence such as gender, birth country or employment. / Syftet med uppsatsen har varit att undersöka den självskattade psykiska hälsan hos socialtjänstens klienter och vad som kan påverka den. En jämförelse gjordes mellan socialtjänstens klienter och övriga respondenter i undersökningsmaterialet. Studien undersökte samband mellan psykisk hälsa och olika variabler, så som kön, ursprungsland samt om man har sysselsättning eller ej. Utöver det undersöktes även hur klienterna upplevde mötet med socialtjänsten och om det fanns samband mellan deras psykiska hälsa och kontakten med socialtjänsten. Materialet som låg till grund för studien var PART-studien (Psykisk hälsa-Arbete-Relationer), som är insamlat av tre forskare; Forsell och Lavebratt från Karolinska Institutet (KI), samt Lundberg från Uppsala universitet, och rörde individers levnadsvillkor och psykiska hälsa. För att analysera användes Goffmans (2011) teori om psykiska och sociala stigman och Ahmedanis (2011) teorianalys om stigmatisering och dess tre olika nivåer av stigma; socialt stigma, självstigma och yrkesverksammas stigma mot klienter. Även tidigare forskning på området har använts för att tolka resultatet, då det förstärkte bilden av hur individers självskattade psykiska hälsa varierar mellan olika grupper i samhället och att psykisk ohälsa är kopplat till stigmatisering. Resultatet visar att den självskattade psykiska hälsan var sämre hos dem som var i kontakt med socialtjänsten, om de var kvinnor, om de var födda utomlands, om de saknade sysselsättning och om de hade en negativ erfarenhet av mötet med socialtjänsten, samt att rollen som klient hos socialtjänsten hade störst påverkan på den psykiska hälsan jämfört med övriga variabler. Det framkom även att de som var i kontakt med socialtjänsten mådde sämst, oberoende av de andra variablernas påverkan så som kön, födelseland eller sysselsättning.