Cette recherche, préoccupée de traiter les questions inaugurées par le mouvement de la Réforme Psychiatrique et, par conséquent, par la restructuration politique de la prise en charge des sujets porteurs de troubles mentaux graves, vise à situer et à délimiter les questions essentielles que ce mouvement impose au champ de la santé mentale. Pour cela, en prenant comme point de départ le texte d’Hannah Arendt intitulé Entre o passado e o futuro, ce travail envisage de souligner la position adoptée par la réhabilitation psychosociale depuis que le mouvement de la Réforme Psychiatrique a été déclenché, ainsi que d’examiner l’évolution du concept de réhabilitation psychosociale et de faire des recherches sur les possibilités d’action dans le cadre de l’attention psychosociale. Cette étude s’est organisée à partir de l’analyse de la dyade expérience-transmission – comprise par le biais du paradigme psychanalytique et basé sur les concepts de transfert de S. Freud et de structure moebienne de Jacques Lacan – et y sont présentés les dispositifs thérapeutiques qui sont en train de développement dans le Caps Cais Mental Centro, tout comme les voies de transmission de l’expérience clinique que de tels dispositifs peuvent rendre possible pour le champ de l’attention psychosociale, en traitant l’expérience du Projeto Insere comme pratique dans le réseau de la réhabilitation psychosociale, sa transmission et sa possibilité d’insertion dans l’histoire du mouvement de la réforme de l’assistance sans le rendre un paradigme ou un protocole. / A presente pesquisa, interessada em abordar questões inauguradas pelo movimento da Reforma Psiquiátrica e, consequentemente, pela reestruturação política do atendimento a sujeitos portadores de transtornos mentais graves, busca situar e delimitar as questões essenciais que este movimento impõe ao campo da saúde mental. Para tanto, tomando como ponto de partida o texto de Hannah Arendt, Entre o passado e o futuro, propõe-se a destacar a posição que a reabilitação psicossocial vem assumindo desde que este movimento foi deflagrado, bem como examinar a evolução do conceito de reabilitação psicossocial e investigar as possibilidades de atuação no campo da atenção psicossocial. Também utiliza-se Walter Benjamin como autor central desta tese para desenvolver o termo experiência. O estudo organizou-se a partir da análise da díade experiência-transmissão – entendida a partir do paradigma psicanalítico e com base no conceito de transferência, de S. Freud, e na noção de estrutura moebiana, de Jacques Lacan – e, nele, são apresentados os dispositivos terapêuticos que vem sendo desenvolvidos no CAPS Cais Mental Centro, assim como as vias de transmissão da experiência clínica que tais dispositivos podem propiciar para o campo da atenção psicossocial, abordando a experiência do Projeto Insere como prática na rede de reabilitação psicossocial, sua transmissão e possibilidade de inserção na história no movimento de reforma da assistência sem torná-lo paradigma ou protocolo. / The present research, concerned with the questions raised by the movement of Psychiatric Reform and, therefore, by the political restructuring of the care of subjects with severe mental disorders, aims to situate and delimit the key questions this movement imposes on the field of mental health. For this task, taking as a starting point Hannah Arendt's text, Between Past and Future, it intends to highlight the place that psychosocial rehabilitation has assumed since this movement was started, as well as to examine the evolution of the concept of psychosocial rehabilitation and to investigate the possibilities of action in the field of psychosocial care. The study was built from the analysis of the experience-transmission dyad – understood from a psychoanalitic paradigm and based on the concepts of transference, of S. Freud, and Moebian structure, of Jacques Lacan –, and it presents the therapeutic tools that have been developed at the Psychosocial Care Center Cais Mental Centro, as well as the paths of transmission of the clinical experience these tools may provide to the field of psychosocial care, addressing the experience of Project Insere as a practice in the network of psychosocial rehabilitation, its transmission and possibility of insertion in the history of the movement of care reform without making it a paradigm or protocol.

Este estudo investigou o processo de politização da dor e da indignação de agentes comunitários que convivem com o HIV/aids. O pressuposto principal é que a condição de soropositividade suscita situações de discriminação e estigmatização, geradores de sofrimento expresso por intensa angústia, sentimentos de vergonha, humilhação e culpa, provocando o isolamento social desta pessoa. A questão norteadora deste trabalho é a verificação de como a participação em uma ONG, onde bons encontros são estimulados, podem ajudar pessoas afetadas pela epidemia da aids a extrapolar esta vivência individualista e estigmatizadora com o HIV/aids para o âmbito da vivência solidária/coletiva, contribuindo para o fortalecimento dos agentes comunitários, não apenas como portadores de direitos, mas como sujeitos de direitos. Foram analisados documentos históricos, entrevistas em profundidade e questionários respondidos por agentes comunitários da ONG-Br situada na grande São Paulo. Os resultados indicaram que a participação em uma ONG contribui para o enfretamento da discriminação e estigmatização das pessoas que convivem com o HIV/aids, com base em um processo de politização concretizado por modos de participação diferentes. Estes modos estão associados com a capacidade de elaboração de questões pessoais/afetivas desencadeadas pela vivência de discriminação e estigmatização ligados ao HIV/aids. Isto sugere a valorização de práticas que fortaleçam a construção de sujeitos portadores de direitos iniciada com a recepção destes agentes na ONG, por exemplo, por meio de projetos de resgate da auto-estima. Compreender e acolher modos de participação diferentes significa valorizar o olhar, valendo-se de um campo psicossocial por excelência, ou seja, captar um processo de mudanças subjetivas e psicológicas em interação necessária com o contexto sócio-histórico e cultural, que leve à emancipação psicossocial, ao mesmo tempo fortalecendo estes sujeitos de direitos e da cidadania plena. / This study has investigated the process of politicization of the pain and the indignation of community agents who live with HIV/aids. The main assumption was that the condition of being HIV positive would rise situations of discrimination and stigmatization that generate suffering expressed by deep anguish, feelings of shame, humiliation, and blame, leading to the social isolation of the individual. The guiding question of this work was how the participation in a Non-governmental Organization (NGO) can help people affected by Aids turn this individualist/stigmatizing experience with HIV into a solidary/collective life experience. These NGOs are able to provide good meetings that could contribute to the strengthening of the community agents, not only as a bearer of rights but also as an individual of rights. Historical documents and interviews have been analyzed in depth as well as questionnaires have been answered by community agents of ONGBr, located in the greater São Paulo area. The results of this study show that the participation of a person who is HIV positive in an NGO contributes to make him/her stronger when facing discrimination and stigmatization. This is possible by a process of politicization made real by different ways of participation. These ways are associated to the capacity of personal/affective questioning triggered by the experiences of discrimination and stigmatization related to Aids/HIV. The study suggests the valorization of practices that build individuals who are bearer of rights. These practices can start right at the reception of this agent by the NGO through projects designated to bring up his/her self-esteem. Understanding and to welcoming different ways of participation mean to value a look from a psycho-social scope, that is, to notice a process of subjective and psychological changes in an inevitable interaction with the social-historical and cultural context, that leads to psycho-social emancipation. This emancipation should run in parallel with the strengthening of these individuals and their full citizenship.

Historicamente, a psiquiatria faz uso do trabalho e da atividade como estratégia central. O Brasil apresenta vários registros históricos, jurídicos, institucionais, teóricos e técnicos da utilização do trabalho de acordo com o paradigma asilar. Os objetivos deste estudo foram contextualizar Serviços de Saúde Mental que utilizam as oficinas como meio de Reabilitação Psicossocial; caracterizar a população atendida, e; identificar as funções, objetivos e propostas das referidas oficinas, através da representação dos profissionais e dos usuários. Para tanto, realizou-se uma pesquisa de natureza qualitativa em Serviços de Saúde Mental dos municípios de Divinópolis e Belo Horizonte, no estado de Minas Gerais. Os recursos metodológicos da investigação foram: observação participante, entrevista semi-estruturada e análise documental. Tabularam-se os dados de acordo com o método do Discurso do Sujeito Coletivo. O referencial teórico foi o do paradigma das práticas em Saúde Mental, compreendendo o modelo asilar e o modelo psicossocial. Os resultados foram reunidos em quatro parâmetros de análise: concepções do "objeto" e dos "meios" de trabalho, formas da organização institucional, formas de relacionamento com a clientela, concepções dos efeitos típicos em termos terapêutico e ético. Os dados deste estudo evidenciam que as oficinas em Saúde Mental avançam em direção à Reabilitação Psicossocial, como dispositivo que materializa o paradigma psicossocial, porém constatou-se que há práticas de retrocesso e/ou repetição da lógica asilar e que as oficinas dos Serviços de Saúde Mental encontram-se em processo de transição paradigmática das práticas da Reforma Psiquiátrica. / Psychiatry has been making use of working activities and crafts production as its central strategies along its history. Brazil has many historical, juridical, institutional, theoretical and technical records of the use of working activities according to the internment paradigms. The aim of this study is to present the context of the mental health services which make use of workshops as a means of psychosocial rehabilitation, to characterize the people who are assisted and to identify the functions, the goals and the proposals of the so called workshops by means of the representations made by professionals and users. In order to achieve such objectives a qualitative research was done on the mental health services of the municipalities of Divinópolis and Belo Horizonte in the state of Minas Gerais. The participative observation, the semi-structured interview and de document analysis were the methodological resources used in the study. The data was processed according to the method of the Discourse of the Colective Subject. The theoretical reference used was the paradigm of the practices in mental health, which comprises the internment model and the psychosocial model. The researcher gathered the results under four parameters of analysis: conceptions of "object" and "means" of work, forms of the institutional organization, ways of relating to the clients and conceptions of the typical effects in therapeutic and ethic terms. The data of this study put in evidence that the workshops in mental health move forward towards the psychosocial rehabilitation, as a practice that gives concreteness to the psychosocial paradigm. Nevertheless we noticed that there are backwarding practices and/or practices of repetittion of the internment logic, and the workshops of the mental health services are under a process of paradigmatical transition of the practices of the Psychiatric Reform.

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2017-06-28T19:53:20Z No. of bitstreams: 1 2016 - Janine Lopes Carvalho.pdf: 1105457 bytes, checksum: 0ca104adc2e98838d0aab84d801f62dc (MD5) / Made available in DSpace on 2017-06-28T19:53:20Z (GMT). No. of bitstreams: 1 2016 - Janine Lopes Carvalho.pdf: 1105457 bytes, checksum: 0ca104adc2e98838d0aab84d801f62dc (MD5) Previous issue date: 2016-03-30 / The late 70 was the beginning of the current movement of Brazilian psychiatric reform. In this period several criticisms of psychiatric care appeared, such as inefficiency of attention, fraud in the financing system and especially the abandonment, abuse and violence suffered by the patients in the main hospices in the country. Progressively, the asylum psychiatric model was being replaced by the model of psychosocial care, in which the Centers for Psychosocial Care (CAPS) have assumed the roles of organizers of the care network, searching forms of singular care, to be developed in the territory of people's lives. It is important the notion of Psychosocial Rehabilitation, in order to develop the work in the new mental health services, which is not just a technical necessity, it is an ethical requirement that should involve all workers and other people that are linked to the health disease process, such as the patients themselves, their families, and finally the entire community. In this context, this research aims to discuss how the psychosocial rehabilitation practice is done, in the services of the professionals of two CAPS of Manhua?u / MG micro region. Therefore, it will be adopted a qualitative research, based on the constructivist paradigm and Hermeneutics Gadamerian. The observed aspects were: poor relation between inter and intra-sectoral network and the acts of municipal administration as a barrier to work concerning the purchase of inputs and training. In regard to psychosocial rehabilitation it was observed that professionals associate the concept of psychosocial rehabilitation to the return to the labor market and it still persists in the minds of professionals the mad stigma as being incapable. / No final da d?cada de 70 deu-se o in?cio do atual movimento pela reforma psiqui?trica brasileira. Neste per?odo surgiram v?rias cr?ticas ? assist?ncia psiqui?trica, tais como: inefici?ncia da aten??o, fraude no sistema de financiamento e, principalmente, o abandono, os maus tratos e a viol?ncia a que eram submetidos os pacientes nos principais hosp?cios do pa?s. Progressivamente, o modelo psiqui?trico manicomial foi sendo substitu?do pelo modelo da aten??o psicossocial, no qual os Centros de Aten??o Psicossocial (CAPS) assumiram a posi??o de organizadores da rede assistencial, assumindo o mandato de agenciar formas de cuidado singular, a serem desenvolvidos no territ?rio de vida das pessoas. Para trabalhar nos novos servi?os de sa?de mental uma importante no??o ? de Reabilita??o Psicossocial, esta n?o ? apenas uma necessidade t?cnica, ? uma exig?ncia ?tica que deve englobar a todos os trabalhadores e demais atores do processo de sa?de doen?a, ou seja, usu?rios, suas fam?lias e, finalmente, a comunidade inteira. Inserida neste contexto, esta pesquisa tem por objetivo discutir como os profissionais de dois CAPS da microrregi?o de sa?de de Manhua?u/MG operacionalizam as pr?ticas de reabilita??o psicossocial nos respectivos servi?os. Para tanto, adotaremos a pesquisa qualitativa, baseada no paradigma construtivista e na Hermen?utica Gadameriana. Foram observados os seguintes aspectos: articula??o prec?ria entre a rede inter e intra-setorial, a administra??o municipal funciona como um entrave para o trabalho em rela??o ? compra de insumos e capacita??o. Em rela??o ? reabilita??o psicossocial observamos que os profissionais associam o conceito de reabilita??o psicossocial como retorno ao mercado de trabalho e que ainda persiste no imagin?rio dos profissionais o estigma do louco como incapaz.

In my thesis I am going to focus on one of the areas of community care for people with mental illness and thus on the area of employment. The main focus of the thesis is on a description of current situation in the provision of the employment support for people with mental illness. The focus is also on the formulation of the specifics of the Employment Support Program for people with mental illness. Another part of my thesis contains empirical investigations focusing on the sustainability and the perspective of the Employment Support Program for people with mental illness. The goal of my thesis is to set up an updated oveview study on the issue of providing employment support for people with metal illness. Powered by TCPDF (www.tcpdf.org)

This diploma thesis deals with the care of people with mental illness. It describes the individual approaches (services and methods) that are used today in working with people with experience of mental illness, and connects these approaches with the role of a social worker. The theoretical part deals with the development of care for people with mental illness, describes the possibilities of services and approaches in mental health care. Then the work defines the term "recovery" and characterizes the "Recovery College", in the country of authors and in the world, as one of the most modern approaches in the care of people with mental illness. The aim of the work is to find out what benefits and differences are perceived between Recovery College and other approaches in the care of people with mental illness by peer lecturers and employees of Recovery College in Prague. In-depth interviews with open-ended questions were used for the solution. Research has shown that Recovery College has a wide range of benefits not only for peer lecturers but also for students - people with experience of mental illness or for society in general. Recovery College is a place for recovery that gives hope to people. Peer lecturers perceive many differences between Recovery College and other approaches which have their...