A INSERÇÃO DOS LEITOS DE SAÚDE MENTAL EM HOSPITAL GERAL NA REDE DE ATENÇÃO PSICOSSOCIAL – RAPS, DE UM MUNICÍPIO DO INTERIOR DO PARANÁ

Abstract

Historically, an internment performs hybrid functions and can create both a form of care and a form of social exclusion. In the scenario of psychiatric reform, proposals for reconfiguration of the place and model of care are identified that permeates the hospitalization device. However, there are some resistance on the implementation of these proposals, constituting an internment as an important object of analysis and reflection. Given this, this paper aims to understand the process of insertion of the Hospital Reference Service (Mental Health Beds in General Hospital - MHBGH) for attention to people suffering from mental disorder and using crack, alcohol and other drugs – on the Psychosocial Care Network (PCN) of a municipality of the interior of Paraná. It also seeks to historically contextualize the implementation of the Mental Health Beds in this municipality, to characterize their mode of operation, analyze the impasses and potentialities of the implementation and promote spaces for discussion and reflection, activate as a co-analysis device with the PCN of the county. It is an intervention research, with a theoretical-methodological approach of Institutional Analysis. Participants are employees working at strategic PCN points: mental health beds in the Hospital, CAPS I, CAPSad, mental health coordination. A survey took place in two moments. In the first, an observation of the daily life of mental health beds was performed and a characterization of the public in the beds (September / 2014 to December / 2017). In the second moment, understood as the one of restitution, the data produced in the first moment were presented and discussed in two focus groups with representatives of the PCN points providing the discussion about the models of attention present in the daily PCN of this municipality, the asylum mode and the psychosocial mode, which in some actions, movements, speeches, co-exist and at other times a greater presence of one or the other is perceived. We highlight some of the powers of this service, which refer to the fact that the MHBGH are territorialized, with hospitalization time of less than 7 days and low number of readmissions. The moment of restitution triggered movements of self-analysis and self-management in the group, in which alternatives emerged from the group itself to solve the problems they listed. The PCNs, composed of several points of attention, including the MHBGH, in general in the country, as well as in this specific municipality, is still a process under construction that continues to have an instituting effect on the consolidated forms of care for the person in psychological distress.