Os loucos de rua e as redes de saúde mental: os desafios do cuidado no território e a armadilha da institucionalização

• Ano de defesa: 2013
• Autor(a) principal: Lisboa, Milena Silva
• Orientador(a): Spink, Mary Jane Paris
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica de São Paulo
• Programa de Pós-Graduação: Programa de Pós-Graduação em Psicologia: Psicologia Social
• Departamento: Psicologia
• País: BR
• Palavras-chave em Português: Pessoas em situação de rua; Loucos de rua; Programa de Saúde da Família Sem Domicílio; Institucionalização; Rede de Saúde Mental
• Palavras-chave em Inglês: Homeless with severe mental distress; Family Health Program for Homeless; Institutionalization; Mental Health Network
• Área do conhecimento CNPq: CNPQ::CIENCIAS HUMANAS::PSICOLOGIA::PSICOLOGIA SOCIAL
• Link de acesso: https://tede2.pucsp.br/handle/handle/17023

This research proposes the investigation of the relationships between homeless (in particular, when they experience mental distress) and health services, focus on the ways they establish support networks, including social, family and institutional resources. The central question of this research addresses how health care networks are setup (especially mental health netwoks), triggered by homeless cared by a team from the Family Health Program for Homeless (PSF-SD), and what are the effects of this care (support the suffering in the territory and production of mental health or institutionalization and social cleaning). During one year, we conducted an ethnography to understand the care relationships established between a team of PSF-SD and homeless, especially following ten cases of psychosocial suffering considered as mental illness. We reflect on the power of the device's PSF-SD, which relies primarily on the ties generated between staff and patients and the care performed in the daily life at the city streets, but that, by themselves, do not account for the needs regarding the mental health of homeless. Our findings revealed the disconnection of the mental health network and the fragile sustenance of the mental suffering in the territory, which keeps the homeless with severe mental distress as depository of the ancient treatment of madness based on social exclusion and disciplining. Their virtual dangerousness and their abnormality performed in the public domain constitute the basis for the lack of assistance of substitute services, which end up creating a circuit of chronicity, produced by constant denials of care network. This circuit works as a vector, centripetal, pointing to the segregation of this institutional residue (the dangerous and abnormal mad homeless ) in a psychiatric hospital. We conclude that the PSF-SD is a device that could break the trap of institutionalization of homeless with severe mental distress, in that, acting as extitution, could articulate the network and sustain mental health care relationships and accountability within and in the interstitial space established "between" institutions