A (des) institucionalização da loucura e dos manicômios: uma análise da implantação dos CAPS no Brasil e de experiências no municipio de Juazeirinho-PB (2004-2020).

Abstract

This work is the result of my experience as a social worker working at CAPS I, in the city of Juazeirinho-PB (2004-2020), from a bibliographical research and from the analysis of archived sources in this care institution. I establish as a general objective to historicize and analyze how the transition of medical-psychiatric practices instituted in asylums and the psychosocial experiences adopted by new mental health institutions took place, comparing forms of interventions in the asylum model with the new ones institutionalized in CAPS in Brazil/Paraíba. The methodological path was a mapping and analysis of Legal Regulations and Standardization in the institutionalization of madness and asylums, using as sources the decrees, laws, ordinances and legislation in general. For the experience in CAPS, in the most recent context of the late 1990s and the first decade of 2000, I analyzed the institutional guidelines that govern the organization, procedures and actions that can and should be developed within the scope of CAPS, regulations established by the Ministry of Health (2010); and multidisciplinary minutes, reports and medical records that are filed at the CAPS. I then analyze how the crisis of authority in asylums and their respective forms of “treatment” of mental illnesses occurred, through the movement for reforms and the anti-asylum struggle in the context of the 1960s/70s in Europe and mainly in Brazil. Also, I historicize how the implementation and legitimization of other therapies for mental illnesses took place in the late 1990s and early 2000s, whether in the international or national and regional scenario, such as the creations and implementations of CAPS in Brazil and Paraíba a from the first decade of 2000, experience of which I am part. In the theoretical foundation of the work, I use Foucault's (1978) concept of disciplinary society, biopower and abnormal, Goffman's (1974) total institutions, and Chartier's (1990) representation category will be very important to understand the representations built about madness to throughout history. Another fundamental concept in the general understanding of individuals considered insane is the notion of the unnameable subject by Certeau (2003), or those associated with non-place, considering that there is a social and symbolic death of these subjects. In order to discuss the process of Psychiatric Reform in Brazil, I base myself on the studies of Machado (1978), Portocarrero (2002), Costa (2006) and Amarante (1995).