Analysis of Nursing Dissertations and Theses on Mental Health, Brazil, 1979-2007

This bibliographic study analyzes scientific texts published in the CEPEn database in the mental health field (1979-2007). A total of 280 abstracts were investigated, of which 208 were Master’s theses. The individuals investigated in these studies were professionals (57), patients (50), and professors and/or students (18). Among the themes addressed between 2000 and 2007 were the following: Nursing Care in Mental Health (40), Perception in Mental Health (37); and Transversality in Mental Health Care (27). This study provided an overview of the scientific research produced in the mental health field in Brazilian nursing graduate programs. We expect this study to elicit reflections concerning mental health care practice and enable new approaches for nursing promoting health and the prevention of diseases in order to enable patients to recover their citizenship, autonomy and quality of life.Se trata de un estudio bibliográfico, con el objetivo de analizar los textos científicos divulgados en la base de datos CEPEn en el área de salud mental (1979-2007). El total de resúmenes estudiados fueron 280, de los cuales 208 eran disertaciones de maestría. Los sujetos que se destacaron fueron los profesionales (57) y pacientes (50). Entre las temáticas abordadas se evidenciaron (2000-2007): el Cuidado de Enfermería en Salud Mental (40) y la Percepción en Salud Mental (37). Este trabajo posibilitó obtener una visión panorámica sobre la producción científica en salud mental en los cursos de Posgraduación en Enfermería en Brasil. Esperamos que el estudio incentive la reflexión sobre las prácticas de cuidado en salud mental y posibilite nuevos abordajes en enfermería con el objetivo de promover la salud y prevenir daños, de forma a favorecer la ciudadanía, la autonomía y la calidad de vida de los sujetos envueltos.Trata-se de estudo bibliográfico, com o objetivo de analisar os textos científicos, divulgados na base de dados CEPEn, na área de saúde mental (1979-2007). O total de resumos estudados foi 280, dos quais 208 constituíam-se de dissertações de mestrado. Os sujeitos que se destacaram foram os profissionais (57) e pacientes (50). Dentre as temáticas abordadas evidenciaram-se (2000-2007): o cuidado de enfermagem em saúde mental (40) e a percepção em saúde mental (37). Este trabalho possibilitou visualização panorâmica acerca da produção científica em saúde mental nos cursos de pós-graduação em enfermagem, no Brasil. Espera-se, aqui, que o estudo suscite reflexões acerca das práticas de cuidado em saúde mental e possibilite novas abordagens em enfermagem, com vistas à promoção da saúde e prevenção de agravos que favoreçam a cidadania, autonomia e qualidade de vida dos sujeitos envolvidos

Jean Colombier and Francois Doublet: the Birth of Psychiatry

(Jean Colombier and Francois Doublet: the Birth of Psychiatry) Jean Colombier and Francois Doublet were the authors of Instructions on How to Control the Insane and Work toward their Cure in Asylums to Which They Are Sent. This book was the first document of a reformist character about the situation of mental patients, and indicated criteria that 19th-century psychiatry should follow. Even though it was in print for only a short time, it became a highly respected work, as its contents were subsequently assimilated by the Committee on Begging at the First Constitutional Assembly, convened to write the Brazilian Constitution.15110811

Reflections on the Case of Ellen West. An anthropological-clinical approach, by Binswanger

The 'Case of Ellen West' is an excellent illustration of why anorexia is not merely a food problem. It reveals a conflict between the ego and the supergo, therefore representing a narcissistic neurosis. The severity of the supergo is based on the rules for fulfilling ideals. The higher the ideals, the less they can be satisfied. For the ego to be the object of loving investment by the supergo, the ego must try to be seen as what it is not, namely, the ideal.11223223

A life moved by commotion

This paper discusses the initial work of constructing a 'skin of words' in a case where a patient made scratches on her arms which she called 'jabbing' or 'poking'. She would scratch herself to the edge of pain, which she called a commotion. This 'commotion pain' was understood as a manifestation of the life drive, with the action directed toward separation, individuation and the confirmation of another different from herself.131163

ON MARX AND MELANCHOLY

ON MARX AND MELANCHOLY After a "tilt" as he calls it, Hello is sent to a psychiatric ward. Hello is a "Marxist" teacher according to the curious description of his medical records. It is from the sessions with a therapist in the hospital that one can understand the meaning of the classification "Marxist" attributed to Helio and the importance of this ideal in his life. It is also from the process of disillusionment of that same ideal that one is faced with Helio's "tilt" and with the first shades of melancholy in this case.431718

Políticas e inovação em atenção à saúde mental: limites ao descolamento do desempenho do SUS Policies and innovation in mental healthcare: limits to decoupling from the performance of the SUS

Analisamos a política brasileira de saúde mental quanto aos aspectos normativos, de demanda, de oferta e de financiamento. Concluímos que a sustentabilidade das inovações da reforma psiquiátrica depende de melhor financiamento e de integração dos serviços comunitários à rede de atenção primária, do desempenho geral do SUS e da redução de serviços exclusivos e autônomos na atenção primária. Existe elevada e crescente pressão de demanda medida em DALY e carga de doença. A redução dos leitos psiquiátricos observada acompanhou a redução sistêmica, porém com redução seletiva para as internações psiquiátricas. Os CAPS apresentam limites institucionais devido ao modelo adotado de administração pública direta e da capacidade de governo municipais. Dados secundários disponíveis revelam que: (i) o SUS tem poder quase monopsônico em serviços ambulatoriais e hospitalares em geral; (ii) os profissionais de saúde mental são predominantemente vinculados ao SUS; (iii) os serviços de saúde mental têm característica predominantemente extra-hospitalar; (iv) um número residual de CAPS dispõem de leitos diários; e (v) o financiamento federal para estas inovações é reduzido.<br>We studied Brazilian policies on mental health with respect to normative, supply and demand and financing aspects. We concluded that the sustainability of innovations in psychiatric reform depends on enhanced financing and integration with primary care community services, on the overall performance of SUS and the reduction of autonomous and exclusive services in primary care. There is high and rising pressure in demand for services measured in DALY and the incidence of disease. The reduction observed in psychiatric beds was accompanied by the systemic reduction, though with selective reduction for psychiatric hospitalizations. CAPS services have institutional limits due to the model adopted of direct public administration and local government capacity. Secondary data available show that: (i) SUS has a virtual monopoly on general outpatient and hospital services; (ii) mental health specialists belong mostly to SUS; (iii) most mental health services are outpatient services; (iv) few CAPS have day-bed services available; and (v) there is reduced federal financing for these innovations