posledních letech časté diskuze na téma ústavní ochranné léčení protialkoholní a protitoxikomanické. Hovoří se o jeho smyslu, délce, neposlední řadě také o bezpečnostních opatření jakým způsobem funguje systém léčebných programů v psychiatrických nemocnicích/léčebnách na Moravě pro pacienty v ústavním ochranném léčení protialkoholním a protitoxikomanickém. Jak dlouhý je časový úsek léčby, v prostředí léčba probíhá, jak jsou jednotlivá oddělení pro léčbu závislostí zabezpečena a jakým způsobem je ústavní ochranné léčení ukončováno. Výzkum je prováděn na základě kvalitativní strategie, s pomocí techniky polostrukturovaných rozhovorů využitím prvků ze zakotvené teorie. Je realizován ve všech psychiatrických léčebnách a nemocnicích na Moravě. Výzkumný soubor tvoří 5 respondentů, jedná se výběr totální. provádění ochranného léč protialkoholního a protitoxikomanického. Nejednotnost spočívá především v ochranného léčení, dále v oblastech charakteristiky oddělení a ve způsobech ukončování nebo přeměny ústavního ochranného léčení. Výzkum také poukazuje na určité shody a to především v názoru na chybějící legislativu pro provádění ochranného léčení, nedostatečné bezpečnostní opatření na jednotlivých odděleních, problematickou komunikaci mezi zdravotnickou institucí a soudci a minimální motivaci k léčbě pacientů v...

O objetivo desta pesquisa é analisar, a partir do referencial da Análise Institucional, a experiência do Clube dos Saberes (CS), um dispositivo que fez parte de uma intervenção institucional, num hospital psiquiátrico privado da cidade de São Paulo, entre os anos 2001 e 2005. O Hospital é uma instituição biforme, com uma organização hierárquica-piramidal e características manicomiais. O CS é uma rede de relacionamentos formada pela troca de saberes e de experiências entre as pessoas de um coletivo, que se organiza democraticamente e visa tanto o crescimento pessoal e individual quanto do próprio coletivo. Ele é proposto ao Hospital como possibilidade de superação da crise enfrentada através da inoculação de uma nova cultura de tratamento, de novas formas relacionamento, de novos modos de funcionamento e organização. A pesquisa envolveu, num primeiro momento, a reconstituição da história dessa experiência a partir da memória da pesquisadora-participante e de registros escritos e, num segundo momento, a seleção de trechos dessa história que possuíam a qualidade de analisador. A análise mostrou que apesar do CS representar uma esperança de mudança e de superação da crise do hospital, ele sofreu resistências por parte da equipe e enfrentou diversos obstáculos: participação pouco expressiva dos trabalhadores do hospital no desenvolvimento do CS; apreensão distorcida ou limitada do projeto; baixa efetividade das parcerias firmadas; persistência e recrudescimento das características manicomiais do hospital; predomínio da organização sobre a clínica e maior atenção à saúde financeira do hospital do que à saúde de seus agentes (pacientes e trabalhadores). Por fim, consideramos que o desenvolvimento do CS foi significativamente prejudicado pela falta de espaços de análise da instituição e de sua alienação. / The object of this research is to analyze, using institutional analysis as a reference, the experience of the Clube dos Saberes, ( Club of knowledge ) or CS, the instrument of an institutional intervention in a private psychiatric hospital in the city of São Paulo between the years of 2001 and 2005. The hospital is a two pronged institution, which has a hierarchicalpyramidal organization with characteristics of an asylum. The CS is a network of relationships formed by the exchange of knowledge and experiences between a collective, that organizes democratically and aims for a personal and individual growth as well as the growth of the collective. This instrument is offered to the hospital as a possibility of overcoming a crisis through the inoculation of a new culture of treatment, of new forms of relationship, of new ways of functioning and organization. The research involved, at first, rebuilding the history of this experience through the memory of the participant-researcher, and through written records, later there was the selection of passages of this history that had the quality of analyzer. The analysis showed that although of the CS represented a hope of change and a chance of overcoming the crisis in the hospital, it suffered resistance from the part of the team and it faced several obstacles: a participation of small significance from the staff in the development of the CS; limited or distorted apprehension of the project; low effectiveness of the established partnerships; the persistence and aggravation of the characteristics of the hospital as an asylum; The predominance of the organization in detriment of the clinic and a greater attention to the financial health of the hospital then the health of its agents ( staff and patients ). In conclusion we find that the development of the CS was significantly hindered by the lack of a space for an institutional analysis and its own alienation.

In British Columbia, individuals with a mental disorder can be hospitalised against their will under the Mental Health Act (1999), when a physician determines that "protection of the person or others" is an issue. Involuntary psychiatric hospitalisation involves a major infringement of an individual's civil liberty. When patients or their representatives disagree with the treatment teams about their involuntary hospitalisation, they can apply for an appeal hearing named the review panel under the Mental Health Act (1999). From a theoretical perspective, the traditional medical model and the social constructionist model, which offer different views concerning individuals with mental illness who are hospitalised against their will, are presented. This theoretical contrast underscores a major dilemma faced by mental health professionals in fostering client self-determination, while they are providing services on the principle of beneficent protection. An empowerment model of social work practice is then described to illustrate how services can be provided to help mental patients regain a sense of control over their lives. Concerns about the current legislation regarding involuntary hospitalisation are also discussed. To supplement the limited number of studies currently available on review panels, a quantitative descriptive study was conducted at Riverview Hospital, the only tertiary psychiatric hospital in British Columbia, surveying the experiences of 39 social workers and physicians with review panels. A questionnaire consisting of 22 Likerttype items was used. Four categories were identified: (a) patient-related issues, (b) effects of review panels on treatment teams, (c) role conflicts, and (d) operational issues. Despite the apparent lack of formal training, social workers and physicians generally reported having adequate knowledge of review panels. Social workers and physicians who were involved more frequently with review panels appeared to have more positive attitudes towards them. Their training pertaining to the Mental Health Act was also significantly related to their attitudes. Neither patients nor their families reportedly had adequate knowledge of the review panel process. Although some positive effects of review panels were acknowledged, staff generally had mixed attitudes about review panels. Guided by an empowerment model, these findings have important implications for social work practice. These include the need for further professional training, improved communication between health professionals and legal advocates, education for patients and families, and the support of patients' collective action, so that review panels can be a more empowering experience for mental patients.

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2007. / Source: Dissertation Abstracts International, Volume: 68-10, Section: B, page: 6595. Adviser: Arch I. Carson. Includes bibliographical references.

Thesis (Ed.D.)--Teachers College, Columbia University, 1996. / Typescript; issued also on microfilm. Sponsor: Susan W. Salmond. Dissertation Committee: Marvin Sontag. Includes bibliographical references (leaves 73-87).

Thesis deals with the ethical problems at the wards of psychiatric hospital. The environment of a psychiatric hospital in the context of its target group psychiatric patients is a source of ethically important situations, which must be solved by the medical social worker. This puts high demands on the worker as he is the/an executive tool of medical social work.The goal of the thesis is to identify ethically important situations, to suggest their solution and eventually to reflect these solutions with the ethical theories, ethical codes, inner rules of the psychiatric hospital and other statutory norms. The structure of the thesis is adjusted to this goal: first, I define the environment of the hospital, describe the target group and medical social worker profession. Secondly, I describe ethical problems identified before, suggest their solutions and reflect them. Finally, in the last part of the thesis, in the discussion, I contemplate about preliminary ethical understanding as a basis for identification of the ethical problems and I ponder other factors that matters in reaching the remedies of ethical problems.

The study sought to analyse the referrals received by a psychiatric unit in a general hospital in the Western Cape by studying the referral letters and the referral responses. The study sought to determine which departments were referring patients and which patients were being referred. The completeness and appropriateness of the referrals were also studied. The major inferences drawn from this study are that health care workers have a poor concept of what information the psychiatric units needs and about the scope and function of the unit. The poor feedback from the psychiatric unit to the referral source is indicative of the poor communication amongst the health care team members. / Health Studies / M.A. (Advanced Nursing Sciences)

Orientador: Silvio José Benelli / Banca: Emerson Elias Merhy / Banca: Silvio Yasui / Resumo: Nosso objetivo nesta pesquisa de mestrado foi problematizar, a partir da Análise Institucional, enquanto lugar teórico-metodológico de investigação, as práticas e os discursos dos atores institucionais que trabalham na organização Saúde Mental, tais como se apresentam nos modos de funcionamento institucional de três hospitais psiquiátricos existentes em uma cidade de médio porte localizada no interior do Estado de São Paulo. Realizamos uma série de visitas de observação participante nesses três estabelecimentos, com a utilização de um diário de campo e entrevistas semi-dirigidas com membros da equipe dirigente e com psicólogos que atuam nesses locais, visando captar o plano do discurso institucional e as contradições existentes na organização Saúde Mental. Como mediação e pano de fundo para nossos objetivos, por meio de uma revisão bibliográfica, examinamos o processo histórico que engendrou a atual sociedade disciplinar enquanto um projeto do Estado de normalização social, que possibilitou o aparecimento dos Hospitais Psiquiátricos. Procuramos estudar os discursos e as práticas institucionais presentes nesses locais, bem como detectar quais são seus possíveis efeitos em termos éticos e de produção de subjetividade. A escolha da Análise Institucional como referencial teórico-metodológico, revelou-se muito útil para pensar a organização Saúde Mental, por permitir considerar o campo social, bem como a transversalidade dos momentos instituintes. A Análise Institucional subsidiou... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Our objective in this master's research was to problematize, from the Institutional Analysis as a theoretical and methodological place of investigation, the practices and discourses of the institutional actors that work in the Mental Health organization, such as they are presented in the institutional modes of functioning of three psychiatric hospitals existing in a medium-sized city located in the interior of the State of São Paulo. We conducted a series of participant observation visits in these three establishments, using a field diary and semi-directed interviews with members of the management team and with psychologists who work in these places, in order to capture the institutional discourse plan and the contradictions existing in the organization Mental Health. As a mediation and background to our objectives, through a bibliographical review, we examine the historical process that engendered the current disciplinary society as a project of the State of social normalization, which made possible the appearance of the Psychiatric Hospitals. We seek to study the discourses and institutional practices present in these places, as well as to detect their possible effects in ethical terms and the production of subjectivity. The choice of the Institutional Analysis as a theoretical-methodological framework proved to be very useful for thinking about the Mental Health organization, since it allows to consider the social field, as well as the transversality of the instituting moments. The Institutional Analysis subsidized the analytical construction of this investigation and the use of its concepts allowed us, when studying the latent plan of these institutional establishments, to capture the lines of transformations that can escape the overcoding power plays practiced in the field of Mental Health... (Complete abstract click electronic access below) / Mestre

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No. of bitstreams: 1 pagnano_jrc_me_assis_int.pdf: 1331946 bytes, checksum: a3eb896856c612c3541ad0c59497b371 (MD5) Previous issue date: 2018-03-12 / Nosso objetivo nesta pesquisa de mestrado foi problematizar, a partir da Análise Institucional, enquanto lugar teórico-metodológico de investigação, as práticas e os discursos dos atores institucionais que trabalham na organização Saúde Mental, tais como se apresentam nos modos de funcionamento institucional de três hospitais psiquiátricos existentes em uma cidade de médio porte localizada no interior do Estado de São Paulo. Realizamos uma série de visitas de observação participante nesses três estabelecimentos, com a utilização de um diário de campo e entrevistas semi-dirigidas com membros da equipe dirigente e com psicólogos que atuam nesses locais, visando captar o plano do discurso institucional e as contradições existentes na organização Saúde Mental. Como mediação e pano de fundo para nossos objetivos, por meio de uma revisão bibliográfica, examinamos o processo histórico que engendrou a atual sociedade disciplinar enquanto um projeto do Estado de normalização social, que possibilitou o aparecimento dos Hospitais Psiquiátricos. Procuramos estudar os discursos e as práticas institucionais presentes nesses locais, bem como detectar quais são seus possíveis efeitos em termos éticos e de produção de subjetividade. A escolha da Análise Institucional como referencial teórico-metodológico, revelou-se muito útil para pensar a organização Saúde Mental, por permitir considerar o campo social, bem como a transversalidade dos momentos instituintes. A Análise Institucional subsidiou a construção analítica dessa investigação e a utilização de seus conceitos nos permitiu, ao estudar o plano latente desses estabelecimentos institucionais, captar as linhas de transformações que podem escapar aos jogos de poder sobrecodificadores praticados no campo da Saúde Mental. O Hospital Psiquiátrico como analisador indica que os atravessamentos de ordem reguladora, de disciplina e de controle costumam superar o projeto oficial dos estabelecimentos da organização Saúde Mental. Detectamos que os problemas dessa organização necessitam serem contextualizados no plano institucional e sócio-político, para não permanecermos em considerações funcionalistas que apenas mascaram a realidade do poder e da política, reduzindo os problemas às questões unicamente de ordem psicológica individuais. / Our objective in this master's research was to problematize, from the Institutional Analysis as a theoretical and methodological place of investigation, the practices and discourses of the institutional actors that work in the Mental Health organization, such as they are presented in the institutional modes of functioning of three psychiatric hospitals existing in a medium-sized city located in the interior of the State of São Paulo. We conducted a series of participant observation visits in these three establishments, using a field diary and semi-directed interviews with members of the management team and with psychologists who work in these places, in order to capture the institutional discourse plan and the contradictions existing in the organization Mental Health. As a mediation and background to our objectives, through a bibliographical review, we examine the historical process that engendered the current disciplinary society as a project of the State of social normalization, which made possible the appearance of the Psychiatric Hospitals. We seek to study the discourses and institutional practices present in these places, as well as to detect their possible effects in ethical terms and the production of subjectivity. The choice of the Institutional Analysis as a theoretical-methodological framework proved to be very useful for thinking about the Mental Health organization, since it allows to consider the social field, as well as the transversality of the instituting moments. The Institutional Analysis subsidized the analytical construction of this investigation and the use of its concepts allowed us, when studying the latent plan of these institutional establishments, to capture the lines of transformations that can escape the overcoding power plays practiced in the field of Mental Health. The Psychiatric Hospital as an analyzer indicates that the crossings of regulatory, discipline and control tend to overcome the official project of the establishments of the organization Mental Health. We have detected that the problems of this organization need to be contextualized in the institutional and socio-political levels, so that we do not remain in functionalist considerations that only mask the reality of power and politics, reducing the problems to the only questions of individual psychological order.

Made available in DSpace on 2016-12-23T14:41:20Z (GMT). No. of bitstreams: 1 Dissertacao de Carla Carrion - Parte 1.pdf: 863464 bytes, checksum: 11c862aa396fd8b22bede81510dd39d8 (MD5) Previous issue date: 2011-08-12 / There is no unique history of madness nor unique way to tell each history. We write here one of the possible histories of Adauto Botelho Psychiatric Hospital (since the 10th of May of 2011 this hospital is called Hospital Estadual de Atenção Clínica HEAC), located in Espírito Santo, Brazil. What matters here is not the accuracy of a timeline, but the flow of speeches and practices. Therefore, we have analysed 102 medical charts of Adauto Botelho Hospital and interviewed 4 hospital employees. We have researched the period from 1954 until 1990. During and after the research, we have discussed the following points: 1. The ways of referring patients to the hospital and how the police was part of this process. 2. The Hospital s Therapeutics, how moralizing they could be and the way they were mirrored on the patients bodies. 3. The struggles and resistances of people who lived and worked in the Hospital. Among the discussion of all these issues, we bring some short histories about the patients, employees and their lives in the hospital. There is no doubt that there are many other questions to discuss, but we write here about what seems to be more intense in the researched material / Não existe uma única história da loucura e da psiquiatria, nem uma única forma de contar cada história. Sabendo disso, o presente trabalho trata de uma história do Hospital Adauto Botelho (desde 10 de maio de 2010, Hospital Estadual de Atenção Clínica Heac), localizado em Cariacica município da Região Metropolitana da Grande Vitória no Espírito Santo. Trazemos essa história não a partir de uma linha do tempo que narre acontecimentos de cada época. Buscamos a fluidez dos discursos e das práticas em lugar da precisão das datas. E, sobre esses discursos e essas práticas, o próprio Hospital tem muito a apresentar, por meio dos prontuários médicos datados desde a inauguração em 1954 e de depoimentos de pessoas que lá tenham trabalhado. Foram analisados 102 prontuários e entrevistadas 4 pessoas. A pesquisa dos prontuários e a realização das entrevistas possibilitaram a discussão as seguintes questões: 1. As formas de encaminhamento dos pacientes para o hospital e o modo como a polícia se inseria nesse processo; 2. As terapêuticas do hospital, seu aspecto moralizante e o modo como elas incidiam sobre os corpos; 3. As lutas e resistências que se presentificavam no cotidiano do hospital. Todas essas questões são o tempo inteiro atravessadas por breves histórias de vidas dos pacientes ali internados e dos funcionários que narraram as vivências no hospital. Não há dúvida de que há inúmeras outras questões a serem debatidas, mas aqui falamos do que nos pareceu mais intenso no material pesquisado