Psychosocial Care Network IN the street and mental health interface: BETWEEN THE INSTITUTED AND THE instituting
Psychosocial Support Systems, Homeless Persons, Integrality in Health, Intersectoral Collaboration.
This research brings up the street and mental health interface, a doubly excluded group, which is historically relegated to the commonplace of crime and craziness, constituting a challenge for health services, especially for the Psychosocial Care Network (PCN), in order to break with the marginalization of services and practices and with the institutionalizing and bureaucratized ways of producing health towards a true integration among actors/services/social movements in line with the principles of the Brazilian Sanitary Reform (BSR) and of the Brazilian Psychiatric Reform (BPR). The core objective of this paper is to analyze how the articulation among the services of the Psychosocial Care Network in Natal/RN is performed in the perspective of the comprehensive care for the homeless persons. This is a qualitative research with descriptive-exploratory approach. Data collection took place by means of ten services representing the five health districts that integrate the components of the Psychosocial Care Network in Natal/RN, establishment of a focus group with professionals of this network and semi-structured interviews with 13 street people who were users of PCN. It received the approval from the Research Ethics Committee of the Onofre Lopes University Hospital of the Federal University of Rio Grande do Norte (HUOL-UFRN) on August 9th, 2018 – CAAE 92971818.1.0000.5292 and opinion nº 2.809.420. The construction of the results entailed movements from concrete to abstract, from singular to plural, seeking new references that illuminate praxis. In order to organize the information, we find support for the entirety of the research object in the Minayo’s operational proposal, drawing up the following categories and subcategories: Psychosocial Care Network: on the tightrope of the care arrangement (subcategories: Other places: challenges for the care in territory; Institutionalization or transient area? In the Network oscillation: the equilibrist hope and the instituting desires); and Homeless Persons in the Psychosocial Care Network: From white blindness to black figures (subcategories – The ship of deviants: places of distrust; Social problem and police case: from guardianship to deathly life; From the multi-territoriality to the nowhere of those outside the area: difficult access to health services; Processes of singularization: transforming into homeless persons. We hope to raise the sonority of the voices that enhance the flow of this network, besides conversely enabling the emergence of other lines eager for transformations. Moreover, we hope that the results may serve as a way of contributing to the feasibility of a national policy for street people in the loco-regional context; and, in the molar dimension, we intend to activate instituting ways of fostering the Brazilian Psychiatric Reform and the defense of the right to health as a matter of citizenship.