Saúde mental e inclusão social: a perspectiva da gestão de um CAPSad III Regional sobre a lógica territorial

Abstract

Drug addicts experience in their daily lives the social exclusion that has dragged on over time, and which is gaining strength due to the moral issue and the stigma that is closely related to chemical dependence. This study critically addresses the social exclusion/inclusion dialectic in the capitalist system and how this presents itself in relation to work with alcohol and drug users. Since the Psychiatric Reform, there have been changes in care and care strategies for this population; territorial and inclusive practices gained centrality. It analyzes how care practices aimed at drug addicts are materializing in the daily practice of community-based services, taking into account the work and the appropriation of the territory as an instrument of rehabilitation, since the autonomy of users and the transformation cultural aspects of the host society are the basis for the process of deinstitutionalization of care practices and social inclusion. The Psychosocial Care Centers for Alcohol and Drugs-CAPSad III are considered strategic devices of great advance in the process of the Brazilian Psychiatric Reform, which aim to work in the territory and the social inclusion of users. However, it is observed that the services that come from inter-municipal consortia (away from the territory of their users) may be acting against the territorial logic, producing a “deterritorialization”, contrary to what is advocated by the Psychiatric Reform. The aim is, therefore, to apprehend and analyze to what extent the social inclusion of users of the CAPSad III Regional has been effected, based on the principles of psychosocial rehabilitation and territorial logic, postulated from the Psychiatric Reform, in Law 10.216/2001. This is a qualitative research, which was investigated in a Regional CAPSad III. The empirical material was produced from the application of a questionnaire and semi-structured interview in the sample, which corresponds to the coordinator of this service. The collected data were analyzed using content analysis. It is concluded, in this study, that the coordinator is aware of the importance of developing social inclusion strategies in the territory, however, the results obtained show that the service studied does not present social inclusion strategies that promote the protagonism and emancipation of the user and that take into account the territorial logic, promoting extraterritorial and service-centered practices. It is not possible to affirm, however, that the absence of appropriation of the territory comes only from the issue of intermunicipality, as two other variables are placed in the crossing of this: the personal/professional conceptions and perspectives of the manager and the contradiction itself in Public Policy of Mental Health. In this sense, despite its limitations, this study is powerful in terms of its findings, which can encourage further investigations and research in greater scopes, with several and diverse CAPSad III Regionals, so that it is possible to understand which of the dimensions discussed, here, more determine the territorial appropriation, or the absence of it, in services of this modality.