Made available in DSpace on 2014-12-17T14:20:24Z (GMT). No. of bitstreams: 1 JulianaRA_ate_pag50.pdf: 1185194 bytes, checksum: 546a7cf4d29e8b61a71cd70ff56b99bb (MD5) Previous issue date: 2006-04-25 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The tesis intends to awake a new way of looking at madness. It presents as reference the Psychiatric Hospital Doctor Jo?o Machado (Natal/RN) and histories of life and narratives of four intern residents. The research in an ethical horizon, intends to give back to the subjects the voices long silented behind the institutions walls by their families and society in general. As well as to open the interpretations of science to receive and to dialogue with other itineraries of thought that, if on one hand does not restitute the explanation of the Real, on the other hand expresses other forms to see the world. Dislocated of the bigger social environment, the people identified as insane, construct their histories endowed with autonomy and displacements in relation to the social rules and structures that characterize our society, as much as in relation to the logical principles of thought that assume an objective and rational reality. As well as a remnants bedspread configured in a complex and unfinished object, the break up of histories of life of the interns, interviews with medical on psychiatrists to the Doctor Jo?o Machado Hospital, documents of the institution and depositions of that house, were the raw material to construct, with this tesis, another chapter of the 'history of madness'. In elapsing of the work innumerable voices have been heard. Some that study the phenomenon of madness, others that live this 'state of the being' in the world. We opt to detaching the first of an open conception on the theme through intellectuals as: Jo?o da Costa Machado, Ulysses Pernambucano, Nise da Silveira and Boris Cyrulnik. They express ethics compromised to the humanity of the being / A disserta??o pretende despertar um novo olhar a respeito da loucura. Apresenta como refer?ncia o Hospital Psiqui?trico Dr. Jo?o Machado (Natal/RN) e as hist?rias de vida e narrativas de quatro internos ali residentes. A pesquisa tem por horizontes ?ticos, devolver ao sujeito as vozes que a fam?lia e a sociedade calaram atr?s dos muros do manic?mio e abrir as interpreta??es da ci?ncia para acolher e dialogar com outros itiner?rios do pensamento que, se n?o rep?em a explica??o do real, expressam outras formas de ver o mundo. Deslocados do ambiente social maior, as pessoas identificadas como loucas constroem suas hist?rias dotadas de autonomia e deslocamentos em rela??o ?s regras e estruturas sociais que caracterizam nossa sociedade, tanto quanto em rela??o aos princ?pios l?gicos do pensamento que sup?em uma realidade objetiva e racional. Assim como uma colcha que une retalhos e se configura num objeto complexo e inacabado, os fragmentos de hist?rias de vida dos internos, as entrevistas com m?dicos psiquiatras ligados ao Hospital Dr. Jo?o Machado, os documentos da institui??o e os depoimentos dos cuidadores daquela casa, foram a mat?ria prima para se construir, com esta disserta??o, mais um cap?tulo da hist?ria da loucura . No decorrer do trabalho foram ouvidas in?meras vozes. Algumas que estudam o fen?meno da loucura, outras que vivem esse estado do ser no mundo. Optamos por destacar o pioneirismo de uma concep??o aberta sobre o tema atrav?s de intelectuais como: Jo?o da Costa Machado, Ulysses Pernambucano, Nise da Silveira e Boris Cyrulnik. Eles expressam uma ?tica comprometida com a humanidade do ser

Fenomenologin har sin grund inom filosofin och intresserar sig för att studera upplevelser och upplevelsen av personens mening, hur personen upplevde en viss händelse och vad personen upplevde. Syftet med den här studien är att studera den versionen av fenomenologi som beskrivs i kurslitteraturen som användes på kandidatprogrammet Socialpsykiatri på Malmö Universitet. Studien är en kvalitativ litteraturstudie. Fenomenologerna är intresserade av att gå tillbaka till själva upplevelsen och studera individens livs erfarenheter av respektive fenomen. Fenomenologin vill studera fenomen och upplevelser för att få ett holistiskt perspektiv av individen. Vid arbete med psykisk ohälsa vill fenomenologerna att den professionella ska ta hänsyn till personens egna livserfarenheter. / Phenomenology is based on philosophy and is interested in studying experiences and the experiences of the person´s meaning, how the person experienced a certain event and what the person experienced. The purpose of this study is to study the version of phenomenology described in the course literature used in the bachelor's program Social Psychiatry at Malmö University. The study is a qualitative literature study. The phenomenologists are interested in going back to the experience itself and studying the individual's life experiences of each phenomenon. Phenomenology wants to study phenomena and experiences in order to get a holistic perspective of the individual. When working with mental illness, the phenomenologists want the professional to take the person's own life experiences into account.

Målet med denna uppsats är att bidra till kvalitetsutveckling gällande behovsbedömning och beslutsformulering vid handläggning enligt socialtjänstlagen. Syftet med uppsatsen är att granska handläggningsprocessen gällande boendestödsbeslut. Med utgångspunkt i denna granskning vill vi komma fram till förslag på förbättringsområden. Förslagen ska vara förenliga med krav från och behov hos lagstiftaren, den enskilde, socialtjänsten/kommunen och biståndshandläggaren. Beslut om boendestöd är idag tidsbegränsade, oftast till ett år, utan att den enskilde egentligen ansökt om det. För den enskilde stödmottagaren innebär detta bristande rättssäkerhet, otrygghet och brist på kontinuitet. Vi har i denna uppsats försökt kartlägga skälen till att besluten ser ut på detta sätt genom att tillämpa en hermeneutisk metod. Av vår genomgång framgår att det inte finns stöd för rutinmässig tidsbegränsning av beslut i lagstiftningen. I vissa fall, där det kan förutses att behovet förändras över tid, kan det dock vara motiverat. Målgruppen för boendestöd har ofta långvariga funktionsnedsättningar och stödbehov som kan antas kvarstå över längre tid än ett år. Enligt de kommunala riktlinjer som vi har granskat är boendestöd en insats som ska tidsbegränsas. De biståndshandläggare som vi har tillfrågat tidsbegränsar i 80 procent av fallen beslut om boendestöd till en giltighetstid på upp till ett år. Det huvudsakliga skälet till detta är att biståndshandläggarna anser att det underlättar uppföljning av besluten. Resultatet av vår studie pekar på att ett antal åtgärder skulle kunna öka kvaliteten på behovsbedömning och beslut om boendestöd. Dessa innebär främst implikationer för kommun, socialtjänst och biståndshandläggare att arbeta vidare med i syfte att skapa en mer rättssäker och evidensbaserad biståndshandläggning. / The intention of this study is to contribute to quality enhancement regarding needs assessment and shaping of decisions of the social service called living support (i.e. boendestöd) according to the law of social service. The aim of this study is to review the process of needs assessment concerning living support. Based on this review we want to give suggestions to possible improvements. Our suggestions must be compatible with demands and requirements from the lawmaker, the individual, the social service/the municipality and the process officer. Today, decision of living support is time limited, usually to a year, without the individual actually having applied for it. This leads to a lack of legal security, personal security and continuity for the individual. In this study, we have tried to locate the reasons for why the decisions are constructed in this way by using a hermeneutical method. Our study shows no support for perfunctory time limiting of decisions according to the law. In some cases where there can be forecasted that the need changes over time, it can though be motivated. The target group for living support often have prolonged impairments and needs of support highly estimated to last more than a year. According to municipal guidelines, reviewed by us, living support is an inset to be time limited. The process officers we have asked in 80 per cent of all cases time limits the decisions up to one year. The main reason for this is that the process officers regard time limiting as making follow-ups of the decisions easier. The result of our study points to a number of measures for increasing the quality of needs assessment and decisions of living support. These measures have implications for the municipality, the social services and the process officers with the purpose of creating a more legally secure and evidence based process of needs assessment.

Die vorliegende Arbeit befasst sich mit dem wissenschaftlichen Werk der DDR Psychiaterin Christa Kohler (1928 – 2004). Fokussiert werden dabei ihre Habilitationsschrift zu sozialpsychiatrischen Problemen bei Neurosen und Psychosen in der zweiten Lebenshälfte sowie ihr selbstständig erarbeitetes Konzept der „Kommunikativen Psychotherapie“. Die Forschungsarbeit Kohlers wird unter Berücksichtigung von themenrelevanter Literatur, Interviews mit Zeitzeugen und Archivmaterialien analysiert und bewertet. Dabei wird auch die Person Kohlers beleuchtet und ihre Arbeit in den wissenschaftshistorischen Kontext eingeordnet.

This work attempts to confront certain political problems created by the individualistic bias in psychoanalytic thinking, and the resulting failure to adequately theorise the importance of social processes. The thesis traces the origins of intrapsychic thinking to Freud's initial move from the seduction theory to the Oedipal theory. This development is offered as a prototype for the debates between conceptualisations of childhood traumatisation as a social problem of actual abuse occurring within dermed power relations, and theories which locate pathology purely within internal conflicts occurring inside the individual. Several criticisms of this shift are offered, and it s impact on later theory is considered. Here a contrast is offered between the theoretical approaches of Melanie Klein and Donald Winnicott, arguing for the usefulness of Winnicott's emphasis on environmental factors within psychodynamic theory. The impact of these theoretical approaches is illustrated through a critical evaluation of Freud's case study of Judge Schreber. Additional historical material is brought in to show the importance of environmental considerations ignored by Freud, and contrasting psychodynamic readings of the case are offered. As an alternative to purely intrapsychic approaches, a reinterpretation of certain strands of Critical Theory is then presented. Adorno's theory of the Authoritarian Personality and Marcuse' s concept of One-Dimensional Man are extended using Winnicott's formulations concerning psychological development. This leads to an examination of the question of the relationship between social structure and individual consciousness. Post-structuralist accounts of language and the construction of identity are explored. These are then developed drawing on theories of ideology, language and consciousness, integrating these with Winnicott's developmental theory to offer an alternative psychodynamic understanding of the relationship between social process and psychopathology. An attempt is made to reformulate - the notions of consciousness and the unconscious in terms of the possibilities and difficulties of representation within available social symbolic codes. In conclusion the it is argued that psychology needs to integrate critical social theory and contemporary understandings of the social construction of consciousness in order to become a meaning force in positive social transformation.

Abstract In recent years in Finland suicide has been discussed in the context of mental health problems. Together with psychiatric disorders, suicide has been seen as a result of adverse social conditions. Occasionally suicide has even been seen as a public health problem. This interpretation has been justified by Finland’s internationally high suicide rates. The inclusion of suicide in medical and psychiatric discussions as well as the production of scientific data on suicide through medical research have resulted in the widely accepted view of suicide as a medical problem. This thesis examines the history of Finnish medical suicide research and the production of psychiatric knowledge on suicide. Finnish suicide research dates back to the middle of the 19th century, when the conception of suicide as a scientific problem arrived in Finland from Continental Europe and the UK. Suicide remained a crime in the Finnish Penal Code until the early 1890s, but the idea of suicide as a medical, rather than moral, legal or theological issue gradually began to gain ground already in the early 19th century. By decriminalizing suicide the Grand Duchy of Finland followed the example set by the Western European countries. The early Finnish suicide research was linked to the French and the English debates on suicide. The emerging European medical conception of suicide was based on social beliefs, psychiatric discussions and early sociological theories rooted in statistical data. As part of the institutional and intellectual development of psychiatry, Finnish suicide research arrived at a new phase after the Second World War. The conception of suicide as an expression of national character or a product of racial characteristics gave way to a new conceptualization based on psychoanalytically oriented psychiatric research. In the 1970s, social psychiatric research began to look for the social determinants behind the suicide rates. This, in turn, prepared the ground for a nationwide suicide prevention project launched in the late 1980s. This thesis aims to shed light on the historical background of this project. The primary source material consists of documents related to Finnish medical suicide research and the discussion about suicide in medical journals in Finland from 1864 to 1985. / Tiivistelmä Itsemurhasta on Suomessa viime vuosina ja vuosikymmeninä puhuttu mielenterveyden ongelmien yhteydessä. Psykiatristen häiriöiden ohella itsemurhat on nähty yhteiskunnallisten olosuhteiden sairastuttavan vaikutuksen tuloksena. Ajoittain itsemurhista on puhuttu jopa kansanterveysongelmana. Tulkintaa on perusteltu viittaamalla kansainvälisesti ja varsinkin länsimaihin verrattuna korkeisiin itsemurhalukuihin. Pelkkiin lukuihin katsominen ei kuitenkaan riitä jonkin ilmiön leimaamiseen terveysongelmaksi. Tulkinnan syntyminen on edellyttänyt lääketieteellisen tutkimuksen kautta syntynyttä tietoa sekä itsemurhailmiön kytkemistä osaksi lääketieteellistä ja psykiatrista keskustelua. Tässä tutkimuksessa tarkastellaan suomalaisen lääketieteellisen itsemurhatutkimuksen historiaa ja itsemurhia koskevan tiedon tuottamista. Suomalaisen itsemurhatutkimuksen juuret ulottuvat 1800-luvun puoleen väliin, jolloin käsitykset itsemurhasta tieteellisenä ongelmana rantautuivat Suomeen Manner-Euroopasta ja Isosta-Britanniasta. Tulkinta itsemurhasta pikemminkin lääketieteellistä kuin moraalista, juridista tai teologista käsittelyä edellyttävänä ilmiönä alkoi voittaa alaa 1800-luvun kuluessa. Dekriminalisoidessaan itsemurhan 1890-luvulla Suomen suuriruhtinaskunta seurasi Länsi-Euroopan maiden esimerkkiä. Varhainen suomalainen itsemurhatutkimus oli kytköksissä 1800-luvun ranskalaiseen ja englantilaiseen psykiatriseen tutkimukseen, yhteiskunnallisiin teorioihin ja väestötilastotietoihin nojaaviin käsityksiin. Osana psykiatrian institutionaalista ja tieteenhistoriallista kehitystä suomalainen itsemurhatutkimus astui toisen maailmansodan jälkeen uuteen vaiheeseen. Käsitykset itsemurhasta kansanluonteen tai rodullisten piirteiden ilmaisuna väistyivät, kun psykoanalyyttisesti orientoitunut tutkimus alkoi etsiä itsemurhan tiedostamattomia psyykkisiä syitä. 1970-luvulla psykiatrinen itsemurhatutkimus suuntautui yksilön mielen ohella yhteiskunnallisiin taustatekijöihin osana sosiaalipsykiatrista tutkimusta. Näin luotiin pohjaa 1980-luvun lopulla käynnistetylle valtakunnalliselle itsemurhien ehkäisyhankkeelle, jonka tieteenhistoriallista taustaa tämä tutkimus valottaa. Tämän tutkimuksen keskeisimmän lähdeaineiston muodostavat suomalaiset lääketieteellisestä näkökulmasta laaditut itsemurhatutkimukset ja itsemurhia käsitelleet tutkimusartikkelit vuosivälillä 1864–1985.

Återhämtning som begrepp återkommer ofta inom socialpsykiatriskt arbete, men vad återhämtning innebär kan skilja sig mellan medicinska respektive sociala och psykologiska diskurser. I denna studie intervjuas sju respondenter som är yrkesverksamma i socialpsykiatriska verksamheter, för att identifiera främjande respektive hindrande aspekter för återhämtning från svåra psykiska problem inom socialpsykiatriskt arbete. I studien tillämpas en kvalitativ metod, med påföljande tematisk analys. Resultaten av studien sammanfattas i fyra kärnteman som främst behandlar ekonomi, ansvar, meningsfullhet, samt relationer och identitet. I dessa teman identifieras främjande respektive hindrande aspekter för återhämtning. Den huvudsakliga slutsatsen som denna studie visar på är att ekonomi är den aspekt som i högsta grad påverkar återhämtning från svåra psykiska problem inom socialpsykiatriskt arbete idag. / Recovery is an often-recurring term within the field of social psychiatry. However, the medical and the social and psychological discourses have conflicting definitions of what recovery entails. In this study seven respondents who are working within social psychiatric agencies have been interviewed, in order to identify aspects which are promoting versus impeding recovery from severe mental health problems within social psychiatric work. This study applies a qualitative method, with a subsequent thematic analysis. The results are summarised using four core themes, which mainly relates to economy, responsibility, meaningfulness, as well as relationships and identity. Within these four themes aspects that are either promoting or impeding recovery are identified. The primary conclusion of this study suggests that economy is the aspect that most impacts recovery from severe mental health problems within social psychiatric work today.

The aim of this study is to gain a deeper understanding of if and how a prevention focused work against addiction is integrated into healthcare administrations in social psychiatry’s regular work. More specifically, this study focuses on what in the professional regular work influences such an approach. Individuals who suffer from comorbidity regarding addiction and mental illness belong to one of the most vulnerable groups in society. This type of dual diagnosis increases the risk of negative consequences for the individual. Previous research has a clear focus on what should be done to achieve an integrated approach and how it should be implemented. The research mentioned presents an ideal picture, although it does not address whether the approach is used in the practice of social work or, if so, how. The discussion regarding integrated prevention work is very relevant in the presence of the two ongoing investigations into comorbidity (SOU 2021:93) and the new Social Services Act (SOU 2020:47). We find a knowledge gap in that the healthcare administrations practical work with an integrated preventions focused approach has not been sufficiently illuminated. A qualitative method in the form of six digital semi-structured interviews was conducted. The theories that have been used to analyze the empirical data are human-treated organizations, Lipsky’s theory of street-level bureaucracy, the concept of room for maneuver and the relational perspective. The results of this study show that a good relationship between the healthcare administrator and the clients is crucial to give the healthcare administrator the opportunity to identify hazardous use, abuse or addiction in clients. The respondents believe that prevention towards escalating use requires a functioning collaboration with the addiction administrators. The possibilities to collaborate are hampered by the specialization in social services and a flexible and vibrant organization is a prerequisite for integrated prevention work to function in the future.

The work deals with the problem of stigma creation among mentally ill people in the contemporary society. A group of people with mental illness is determined by defining the terms of mental health and mental illness. The consequences of the illness on the quality of life are described. A history of mental health care and the development of the opinions on the group of mentally ill people are mentioned. The problems of stereotypical attitudes to mentally ill are dealt with, together with the importance of impact of stigmas on the personality of the mentally ill and their environment. In the last part the possibilities of shifting off the stigmas are eliminated, respecting the experience in the field of mental health care abroad.

The Brazilian psychiatric reform, in line with the current mental health policies, points to the production of care rooted in the user territory as a strategy to increase the autonomy of the users and substitute hospitalizations in psychiatric hospitals. At the crossroads between this public policy perspective and some experiences in assisting at a CAPS, we seek to elucidate experienced challenges among users, health professionals and other actors, facing the challenge of producing mental health in a city in the northeastern. Citizenship, mental health and madness are interwoven with the control in an open pit promoted dynamics where there are no psychiatric hospital walls that demarcate where freedom is curtailed. Through the narrative of some scenes from the shocks of the mental health care field of the city surveyed, the rescue of brazilian public policy and history produced by Michel Foucault about the madness and the birth of Psychiatry, we point out possible resistances on the experience with people known as crazy. / A reforma psiquiátrica brasileira, em consonância com as atuais políticas de saúde mental, aponta para a produção de cuidado enraizada no território do usuário como estratégia para aumentar a autonomia dos usuários e substituir os internamentos em hospitais psiquiátricos. No cruzamento entre esta perspectiva das políticas públicas e algumas passagens da experiência na assistência em um CAPS, buscamos elucidar embates vividos entre usuários, profissionais de saúde e outros atores, diante do desafio de produzir saúde mental em uma cidade interiorana do Nordeste. Cidadania, saúde mental e loucura se entrelaçam com o controle promovido a céu aberto, numa dinâmica onde não existem os muros do hospital psiquiátrico que demarcam até onde a liberdade é cerceada. Através da narrativa de algumas cenas do exercício no campo assistencial da saúde mental da cidade pesquisada, do resgate das políticas públicas brasileiras e da história produzida por Michel Foucault acerca da loucura e do nascimento da psiquiatria, procuramos assinalar resistências possíveis na experiência com o dito louco.