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The participation of family in Mental Health treatment as practice in the quotidian of the service

Full text
Author(s):
Pedro Pablo Sampaio Martins
Total Authors: 1
Document type: Master's Dissertation
Press: Ribeirão Preto.
Institution: Universidade de São Paulo (USP). Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (PCARP/BC)
Defense date:
Examining board members:
Carla Guanaes Lorenzi; Emerson Fernando Rasera; Clarissa Mendonça Corradi Webster
Advisor: Carla Guanaes Lorenzi
Abstract

Concerns with the participation of family in mental health treatments in Brazil have historically aroused from the movement of psychiatric reform, which aims at changing the logic that underlies the production of healthcare. Ever since then, it has been possible to observe tensions in this field, characterized by the presence of different discourses regarding family, their participation, involvement and responsibility in relation to mental health and to its needed care. This study aims to understand how relatives of mental health patients make meanings about their own participation in treatment. We conducted individual, semi structured interviews with ten of those relatives who were seen in a mental health day service in a city in the state of São Paulo, Brazil. The participation of these family members in treatment was the central theme of these interviews, which focused especially on their understandings about family, mental health and treatment. The interviews were recorded in audio, fully transcribed and later analyzed through qualitative procedures, based on the contributions of the social constructionist movement in science. First, we conducted a thematic analysis, which was organized in three time-based categories: 1) Families in pain, that refers to the lives of the family members before their participation in treatment, and that has as themes the arising of the illness, its consequences to family life, and the families seek for help in health services; 2) Families in treatment, which contemplates five forms of participation in the program for family assistance, namely the care for families, the learning about the mental illness, the transformation of family relationships, the care for the family member who is being treated, and the mutual care between different families; 3) Families in development, under which are the themes regarding the interviewees current lives, considering the improvement of the patients situation, the challenges family members have faced since they left the service, and their imagined perspectives for life. Next, we analyzed the communicational process in one of the interviews that illustrated how every description of the participation of the family member in treatment was constructed as an interactional product during the research process. We realized how certain stances of the researcher invited a process of participation by the family member very similar to that which we wanted to investigate. We concluded that the participation of these family members in treatment is constructed as a possibility not only through inviting them to participate, but through an effective and daily investment in the quality of the relationships between different social actors involved in the process (patients, family members, healthcare practitioners). We characterized this as an ongoing process, constructed at every moment during everyday health practices. This understanding calls attention to the micro politics of production of healthcare, and to the necessity of an attention to communicational and relational processes involved in the participation of family in the quotidian of the institution. We concluded by pointing to the challenge of creating, in daily practices, ways of making this care happen. For that, we highlighted the importance of moving away from an understanding of a family being treated to one that considers a family who needs care. The transformation of this understanding considers the negative effects that discourses blaming families for the disease create in society. We hope to contribute to changes in these discourses towards others that, intertwined to practices, may actually be supportive and helpful to families who suffer. (The São Paulo Research Foundation). (AU)

FAPESP's process: 11/02365-0 - Meanings constructed by relatives of mental disorders patients about family participation in treatment
Grantee:Pedro Pablo Sampaio Martins
Support Opportunities: Scholarships in Brazil - Master