[The dynamics of mental health care: health professionals' signs, meanings, and practices in a Center for Psychosocial Care in Salvador, Bahia State, Brazil].
This article analyzes the system of signs, meanings, and practices concerning mental health used by health professionals at a Center for Psychosocial Care (CAPS) in Salvador, Bahia State, Brazil. A nine-month ethnographic observation was conducted at the center, complimented by interviews and focus groups involving all staff with university and secondary schooling. Three models of care coexist at the center: the humanized biomedical model; the psychosocial model, with an emphasis on the institution; and the psychosocial model, with an emphasis on the territory, thus highlighting elements of conflict between professionals in their perception of the desired psychiatric reform and the practices to be adopted in this perspective. When compared to the asylum-based model, there is unquestionable evidence of a transformation in the care provided, mainly based on a "clinic of encounter", rooted in questioning, thinking-through, and experimenting dialogical interpersonal relationships as well as the ability to listen to the other, which explains the clinical and social impact of this approach.
Nunes
Mônica
M
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil. nunesm@ufba.br
Torrenté
Maurice de
Md
Ottoni
Vitória
V
Moraes Neto
Valfrido
V
Santana
Mônica
M
D001291:Attitude of Health Personnel; D001938:Brazil; D003155:Community Mental Health Centers; D003688:Deinstitutionalization; D005192:Family Health; D018166:Health Care Reform / Q000458:organization & administration*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D001523:Mental Disorders / Q000628:therapy*; D008603:Mental Health; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D011320:Primary Health Care; D011570:Psychiatry / Q000458:organization & administration; D011574:Psychoanalytic Theory