Fazendo história: Os Centros de Atenção Psicossocial Infantojuvenis III da cidade de São Paulo

• Ano de defesa: 2022
• Autor(a) principal: Moura, Beatriz Rocha
• Orientador(a): Matsukura, Thelma Simões
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Carlos; Câmpus São Carlos
• Programa de Pós-Graduação: Programa de Pós-Graduação em Terapia Ocupacional - PPGTO
• Palavras-chave em Português: Políticas públicas; Serviços comunitários de saúde mental; Centro de atenção psicossocial infantojuvenil; Intervenção na crise; Criança; Adolescente; Terapia ocupacional
• Palavras-chave em Inglês: Public policies; Community mental health services; Child and adolescent psychosocial care center; Crisis intervention; Child; Adolescent; Occupational therapy
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA
• Link de acesso: https://repositorio.ufscar.br/handle/20.500.14289/17029

Public policies on children's and youth mental health were consolidated late in the Brazilian public health scenario, starting their construction only in 2002, with the creation of the Children and Youth Psychosocial Care Centers III (CAPSij). Despite the advances made in the last two decades, it is verified that attention to the crisis of children and adolescents is briefly addressed in the guiding documents of the Ministry of Health, evidencing a gap in the Psychosocial Care Network for this population. CAPSij III, with 24-hour operation, has been presented as a powerful equipment for this care, and despite not being provided in the ministerial ordinances, the city of São Paulo has invested in the implementation of these services. The research aimed to rescue the history of implementation of CAPSij III in the city of São Paulo and to understand the function of these tools in the attention to the crisis of children and adolescents at the RAPS from São Paulo. It is a qualitative research that utilizes the Triangulation of Methods and is composed of two studies. In the study 1, the Hybrid Oral History method was used and had the participation of nine components of the Technical Area of Mental Health of the Municipal Health Department of São Paulo and one of the first managers of the first CAPSij III. The study 2 is a survey, exploratory and descriptive study, with the participation of six CAPSij III managers from the city of São Paulo. For both studies, the data analysis method used was Content Analysis. The results of the study 1 reveal that the first CAPSij III was conceived by components of the Technical Area who believe in the construction of this equipment as a substitute for the hospitalization of children and adolescents, enabling the provision of comprehensive and territorial care. After this first experience, the expansion of CAPSij III was proposed, with the implementation of one CAPSij III per Regional Health Coordination. This study also revealed that the decision and involvement of the manager with the Psychiatric Reform, the presence of democratic-participatory governments, the closing of agreements with Psychiatric Hospitals, together with the investment in CAPSij III were key points for a process of transformation in crisis care to be effective. The study 2, on the other hand, presents as results a characterization of the current CAPSij III in the city of São Paulo, it explains how the process of integral reception in the services takes place, the access flow, the work dynamics, the care strategies and the sharing of cases with CAPSij II, revealing the potential and difficulties experienced by CAPSij III in the attention to the crisis of children and adolescents. Also, some important points are listed for the implementation of good practices in CAPSij III, such as psychosocial understanding of the crisis, the presence of multi-team professionals at night and on weekends, the protagonism and participation of users and family members throughout the care process, construction of care effectively shared between CAPSij II and CAPSij III and investment in collective spaces such as meetings and clinical-institutional supervision for all team professionals. Through the analysis of the results of both studies, the complexities present in the care of this population were also highlighted, such as the hospitalization of children and adolescents, the use of restraint in CAPSij III, the difficulties experienced with the network and the judicialization of cases. It is expected that this research might contribute to the advancement of the field, inspire and support the implementation of more CAPSij III throughout Brazil, offering support for the construction of public policies consistent with the needs of children and adolescents in psychological distress, in addition to address important issues to future studies.