Entrelaçamento dos marcadores sociais na reinserção social dos beneficiários do “Programa de Volta para Casa” em Santos
Data
2023-05-10
Autores
Massa, Paula Andrea 
Orientadores
Moreira, Maria Inês Badaró
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: Fruto da Reforma Psiquiátrica Brasileira, o “Programa de Volta para Casa” (PVC), é um dos pontos de atenção das Estratégias de Desinstitucionalização da Rede de Atenção Psicossocial do SUS. Trata-se de subsídio financeiro pago diretamente às pessoas egressas de internações psiquiátricas para viabilizar o acesso a direitos e ao exercício da cidadania. Objetivo: Compreender como marcadores sociais se entrelaçam na reinserção social dos beneficiários do programa moradores de Santos, no litoral paulista. Método: Pesquisa social em saúde, com inspirações etnográficas, que usou a entrevista semiestruturada e a observação participante como ferramentas de coleta de dados. Resultados: Foram localizados 35 beneficiários, dos quais 19 entrevistados, com idade média de 56 anos; maioria negra (13); metade mulheres (10) e migrantes nordestinos ou seus descendentes (8). A maior parte não escolarizada, com renda média de um salário mínimo, usuária de serviços públicos de saúde e transporte, cliente de estabelecimentos comerciais, moradora de imóveis alugados. A análise do cotidiano de sete participantes, à luz das perspectivas da desinstitucionalização e da interseccionalidade, mostrou que os marcadores sociais que fazem a diferença na reinserção social são raça/cor, gênero, classe e origem. O egresso de internação psiquiátrica negro, pobre ou migrante/descendente é mais prejudicado no estabelecimento de relações comunitárias de afeto e confiança e de pertencimento ao território por meio do acesso à moradia digna. No entrelaçamento com o marcador capacitismo, os anos de isolamento social foram uma dobra, uma segunda camada de discriminação. A desospitalização promovida pelo PVC faz a desdobra e revela que é o sistema de opressão racista, colonial e sexista que mantém a condição de desvantagem social, tanto no acesso ao programa quanto na reinserção social na cidade. Conclusão: O alcance da reparação e justiça social pela a reabilitação psicossocial é limitada. Sob essa lente teórico-metodológica, sugerimos radicalizar o PVC com estratégias decoloniais do cuidado para a liberdade. No âmbito operacional, sugerimos também que o acesso de todos que cumprem os critérios de inclusão no programa seja garantido independentemente da iniciativa local, com investimento na participação da mulher negra na elaboração de estratégias para o cuidado e formação de coalizões políticas. No âmbito clínico, indicamos a conscientização dos beneficiários sobre os mecanismos de opressão e a inserção dos fatores sociais locais na análise da manutenção da desigualdade no acesso à cidade.
Introduction: Part of the Brazilian Psychiatric Reform, De Volta pra Casa Program (PVC – Back Home Program) started in 2003 as one of the Deinstitutionalization Strategies of the Psychosocial Care Network. PVC is a financial resource paid to whom have been discharged from a long psychiatric hospitalization, aiming for rights access and the exercising of citizenship. Objective: To understand how social differences intertwine with the insertion of PVC beneficiaries living in Santos. Method: It is social research on health, with ethnographic inspirations, which has semi-structured interviews and participant observation as data collection tools. Results: 35 beneficiaries were found and 19 were interviewed. The average age is 56 years old; most identify themselves as black (13), are women (10) and eight are northeastern migrants or their descendants. Most are unschooled; have an average income of a minimum wage, access public health services, public transportation and commercial establishments and live in rented and precarious habitation. Seven of the interviewees participated in a daily life analysis, based on a deinstitutionalization and intersectionality perspective, which showed that the social differences that make the difference in social insertion are race, gender, class and origin. The black, poor or migrant/descendants who leave psychiatric hospitalization are harmed in establishing affective and trust community relationships and in belonging to the territory through access to decent housing. In the interweaving with the Capacitism, it was identified that the years of social isolation make a fold, a second layer of discrimination. The de hospitalization promoted by PVC makes it evolve and reveals that it is the racist, colonial and sexist system of oppression that maintains the condition of social disadvantage, both without access to the program and in social reintegration in the city. Conclusion: We conclude that to achieve protection and social justice, psychosocial rehabilitation is limited. Under this theoretical-methodological lens, we suggest radicalizing PVC with decolonial strategies of care for freedom. At the operational level, we suggest guaranteeing access to everyone who meets certain criteria, without depending on local initiative. Recommend investing in enhancing the culture of black women in the elaboration of strategies for care and in the formation of political coalitions to expand access to rights. In the clinical scope, we indicate the awareness of the mechanism of oppression and the analysis of how the social factors maintain inequality in the access to the city.
Introduction: Part of the Brazilian Psychiatric Reform, De Volta pra Casa Program (PVC – Back Home Program) started in 2003 as one of the Deinstitutionalization Strategies of the Psychosocial Care Network. PVC is a financial resource paid to whom have been discharged from a long psychiatric hospitalization, aiming for rights access and the exercising of citizenship. Objective: To understand how social differences intertwine with the insertion of PVC beneficiaries living in Santos. Method: It is social research on health, with ethnographic inspirations, which has semi-structured interviews and participant observation as data collection tools. Results: 35 beneficiaries were found and 19 were interviewed. The average age is 56 years old; most identify themselves as black (13), are women (10) and eight are northeastern migrants or their descendants. Most are unschooled; have an average income of a minimum wage, access public health services, public transportation and commercial establishments and live in rented and precarious habitation. Seven of the interviewees participated in a daily life analysis, based on a deinstitutionalization and intersectionality perspective, which showed that the social differences that make the difference in social insertion are race, gender, class and origin. The black, poor or migrant/descendants who leave psychiatric hospitalization are harmed in establishing affective and trust community relationships and in belonging to the territory through access to decent housing. In the interweaving with the Capacitism, it was identified that the years of social isolation make a fold, a second layer of discrimination. The de hospitalization promoted by PVC makes it evolve and reveals that it is the racist, colonial and sexist system of oppression that maintains the condition of social disadvantage, both without access to the program and in social reintegration in the city. Conclusion: We conclude that to achieve protection and social justice, psychosocial rehabilitation is limited. Under this theoretical-methodological lens, we suggest radicalizing PVC with decolonial strategies of care for freedom. At the operational level, we suggest guaranteeing access to everyone who meets certain criteria, without depending on local initiative. Recommend investing in enhancing the culture of black women in the elaboration of strategies for care and in the formation of political coalitions to expand access to rights. In the clinical scope, we indicate the awareness of the mechanism of oppression and the analysis of how the social factors maintain inequality in the access to the city.
Descrição
Citação
MASSA, Paula Andrea. Entrelaçamento dos marcadores sociais na reinserção social dos beneficiários do “Programa de Volta para Casa” em Santos. 2023. 193 f. Tese (Doutorado Interdisciplinar em Ciências da Saúde) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2023.