Multicenter Adaptation Of The Guide Autonomous Management Of Medication

Rising psychotropic prescriptions and low empowerment of mental health users hamper qualified delivery of mental health services in Brazil and countries providing universal healthcare. This multicentric study performed in three Brazilian cities aimed to develop the Brazilian translation and adaptation upon the Quebecoise-Canadian Gaining Autonomy and Medication (GAM) Guide; and to evaluate the impact of its use on mental health workers education. Intervention Groups (IGs) were held to provide experience sharing on medication as relevant issues were brought up by the guide. Pre- and post- IGs focus groups were held. Major changes to the original text of the Quebecoise handbook were necessary according to the Brazilian scenario. Results show the Brazilian version as a powerful strategy to promote users' participation in decision making concerning treatment as well as the mental health services they are in treatment at. The handbook also has a positive impact on staff education.1643967980Secretaria Municipal de Campinas (2010) Informações da Secretaria Municipal de Campinas Departamento de Saúde, Saúde Mental, , CAMPINASCampos, G.W.S., (2000) Um Método Para Análise E Co-gestão De Coletivos - a Construção Do Sujeito, a Produção De Valor De Uso E a Democracia Em Instituições: O Método Da Roda, , São Paulo: HucitecCampos, G.W.S., Onocko, R.C., Co-construção de autonomia: O sujeito em questão (2005) A Construção Da Clínica Ampliada Na Atenção Básica, pp. 86-107. , CAMPOS, G.W.SMINAYO, M.C.SAKERMAN, M.CUNHA, G.T. (Orgs), São Paulo: HucitecFurtado, J.P., Onocko, R.C., Participation, knowledge production, and evaluative research: Participation by different actors in a mental health study (2008) Cad Saude Publica, 24 (11), pp. 2671-2680Gadamer, H.G., (1997) Verdade E Método: Traços Fundamentais De Uma Hermenêutica Filosófica, , Petrópolis: Editora VozesHull, S.A., Aquino, P., Cotter, S., Explaining variation in antidepressant prescribing rates in east London: A cross sectional study (2005) Fam Pract, 22 (1), pp. 37-42International Narcotics Control Board (2010) Psychotropic Substances, , http://www.incb.org/pdf/technical-reports/psychotropics/2010/Psychotropic_Substances_Publication_2010.pdf, VIENNA. United Nations, Vienna: UN, Disponível em, Acesso em: 04 jul. 2012Kinoshita, R.T., Contratualidade e reabilitação psicossocial (1996) Reabilitação Psicossocial No Brasil, pp. 55-59. , PITTA, A. (Org.), São Paulo: HucitecMaragno, L., Prevalence of common mental disorders in a population covered by the Family Health Program (QUALIS) in Sao Paulo, Brazil (2006) Cad Saude Publica, 22 (8), pp. 1639-1648Marques, C.C., (2012) Entre Nós: Sobre Mudar De Lugar E Produzir Diferenças, , 2012. Dissertação (Mestrado) - Instituto de Psicologia, Universidade Federal do Rio Grande do Sul, Porto AlegreOnocko, C.R.T., Avaliação de estratégias inovadoras na organização da Atenção Primária à Saúde (2012) Rev. Saúde Pública, 46 (1). , http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102012000100006&lng=en&nrm=iso, São Paulo, Feb, Disponível em, Acesso em: 04 jul. 2012. Epub Dec 13,2011. http://dx.doi.org/10.1590/S0034-89102011005000083Onocko, C.R.T., Furtado, J.P., Narratives: Use in qualitative health-related research (2008) Rev Saude Publica, 42 (6), pp. 1090-1096Otanari, T.M.C., (2011) A Experiência De Participação Dos Residentes De Psiquiatria E Saúde Mental Nos Grupos De Gestão Autônoma Da Medicação? (GAM): Possíveis Efeitos Na Formação, , 2011. Dissertação (Mestrado). Faculdade de Ciências Médicas, Universidade Estadual de Campinas, CampinasRegier, D.A., The NIMH Epidemiologic Catchment Area Program: Historical context, major objectives, and study population characteristics (1984) Arch Gen Psychiatry, 41 (10), pp. 934-941Rodriguez, L., Perron, N., Ouellette, J.N., Psicotrópicos e saúde mental: Escutar ou regular o sofrimento? (2008) Pesquisa Avaliativa Em Saúde Mental: Desenho Participativo E Efeitos Da Narratividade, pp. 125-162. , ONOCKO CAMPOS, R.FURTADO, J.P.PASSOS, E.BENEVIDES, R. (Orgs), São Paulo: HucitecRodriguez, L., Corin, E., Poirel, M.L., Le point de vue des utilisateurs sur l'emploi de la médication en psychiatrie: Une voix ignorée (2001) Revue Québécoise De Psychologie, 22 (2), pp. 1-23Ricouer, P., (1997) Tempo E Narrativa, , Campinas: PapirusRicouer, P., (1990) Interpretação E Ideologias, , Rio de Janeiro: Francisco AlvesSantos, D.V.D., (2009) Uso De Psicotrópicos Da Atenção Primária Do Distrito Sudoeste De Campinas E Sua Relação Com Os Arranjos Da Clínica Ampliada: Uma Pedra No Sapato, , 2009. Dissertação (Mestrado) - Faculdade de Ciências Médicas, Universidade Estadual de Campinas, CampinasVedia, U.C., Study of use of psychiatric drugs in primary care (2005) Aten Primaria, 36 (5), pp. 239-245Winter, F., de Présentation, M., (2007), http://www.ladroit.org/texteforumgam.pdf, François Winter, coordonnateur de L'A-DROIT de Chaudière-Appalaches, lors de la 4ième table ronde du forum international sur les psychotropes des 3-4-5 avril, Disponível em, Acesso em: 04 jul 201

Autonomous Medication Management: An Analytical Intervention In Mental Health Care Services [a Gestão Autônoma Da Medicação: Uma Intervenção Analisadora De Serviços Em Saúde Mental]

In a context of high rates of medicalization of the population and in light of the scantly critical use of psychiatric medications in mental health services, this paper reports aspects of a qualitative study that had the opportunity to intervene in care practices in three major Brazilian cities. Following the principle of Brazilian Psychiatric Reform championing users' rights to participate in decisions about their treatment, the research intervened in psychosocial care centers (CAPS) seeking the empowerment of the users regarding the use of drugs in their therapeutic projects. Interviews were conducted and focus groups set up. From this recorded material, the paper analyzed some situations that, among other things, attested to the difficulty of avoiding the exercise of power over users via the administration of psychotropic drugs. Little dialogue about drugs, and the existence of stigmatization spaces where user rights are inhibited or "accepted with caution," was also detected in the services surveyed.181028892898Jacob, K.S., Sharan, P., Mirza, J., Garrido-Cumbrera, M., Seedat, S., Mari, J.J., Sreenivas, V., Saxena, S., Global mental health 4-mental health systems in countries: Where are we now? (2007) Lancet, 370 (9592), pp. 1061-1077Onocko Campos, R., Gama, C.A., Ferrer, A.L., dos Santos, D.V.D., Stefanello, S., Trape, T.L., Porto, K., Mental health in primary care: An evaluative study in a large brazilian city (2011) Cien Saude Colet, 16 (12), pp. 4643-4652Elliot, C., (2003) Better then well: American medicine meets the american dream, , New York: W. W. NortonBell, S.E., Figert, A.E., Medicalization and pharmaceuticalization at the intersections: Looking backward, sideways and forward (2012) Soc Sci Med, 75 (5), pp. 775-783Conrad, P., Leiter, V., Medicalization, markets and consumers (2004) J Health Soc Behav, 45 (SUPPL.), pp. 158-176Illich, I., (1975) A expropriação da saúde: Nímesis da mecicina, , 2a Edição. Rio de Janeiro: Nova FronteiraElliot, C., (2010) White coat, black hat: Adventures on the dark side of medicine, , Boston: Beacon PressConrad, P., Barker, K.K., The social construction of illness: Key insights and policy implications (2010) J Health Soc Behav, 51 (SUPPL.), pp. S67-S79Conrad, P., McKie, T., Mehrotra, A., Estimating the costs of medicalization (2010) Soc Sci Med, 70 (12), pp. 1943-1947Fulford, K.W.M., Bringing together values-based and evidence-based medicine: UK department of health initiatives in the 'personalization' of care (2011) J Eval Clin Pract, 17 (2), pp. 341-343Deegan, P.E., Drake, R.E., Shared decision making and medication management in the recovery process (2006) Psychiatr Serv, 57 (11), pp. 1636-1639Lopes, T.S., Dahl, C.M., Serpa Jr., O.D., Leal, E.M., Campos, R.T.O., Diaz, A.G., The process of recovery in the perspective of persons with schizophrenia spectrum disorders and of psychiatrists working at psychosocial health care services (2012) Saúde Soc. São Paulo, 21 (3), pp. 558-571Onocko Campos, R.T., Palombini, A.L., Silva, A.E., Passos, E., Leal, E.M., Serpa Jr., O.D., Marques, C.C., Stefanello, S., Multicenter adaptation of the guide for autonomous management of medication (2012) Interface (Botucatu), 16 (43), pp. 967-980(2006) Balises pour une approche alternative des pratiques de soutien communautaire en santé mentale, , Regroupement des ressources alternatives en santé mentale du Québec (RRASMQ), Québec: RRASMQVasconcelos, E.M., Dispositivos associativos de luta e empoderamento de usuários, familiares e trabalhadores em saúde mental no brasil (2007) Revista Vivência, (32), pp. 173-206Campos, G.W.S., (2000) Um método para análise e co-gestão de coletivos, , São Paulo: HucitecOnocko Campos, R.T., Campos, G.W.S., Co-construção de autonomia: O sujeito em questão (2006) Tratado de Saúde Coletiva, pp. 669-714. , In: Minayo MCS, Akerman M, Drumond Júnior M, Carvalho YM, organizadores., São Paulo: HucitecPassos, E., Barros, R.B., A cartografia como método da pesquisa-intervenção (2009) Pistas do método da cartografia: Pesquisa-intervenção e produção de subjetividade, pp. 17-31. , In: Kastrup V, Escóssia L, organizadores, Porto Alegre: SulinaLourau, R., Objeto e método da análise institucional (2004) Analista em tempo integral, pp. 66-86. , In: Altoé S, René Lourau R, organizadores., Campinas: HucitecOnocko Campos, R.T., Furtado, J.P., Narratives: Use in qualitative health-related research (2008) Rev Saude Publica, 42 (6), pp. 1090-1096Ricouer, P., (1997) Tempo e narrativa, , Campinas: PapirusCorin, E., Se rétablir après une crise psychotique: Ouvrir une voie? Retrouver sa voix? (2002) Santé Mentale Au Quebéc, 27 (1), pp. 65-82Rodriguez, L., Nouveaux paramètres pour l'élaboration des pratiques de soutien communautaire: Contribuition des organismes communautaires et alternatifs au québec (2011) Santé Mentale Au Quebéc, 36 (1), pp. 35-56Santos, N.R., Public healthcare policy in brazil: Crossroads and choices (2008) Cien Saude Colet, 13 (SUPPL. 2), pp. 2009-2018Davidson, L., Drake, R.E., Schmutte, T., Dinzeo, T., Andres-Hyman, R., Oil and water or oil and vinegar? Evidence-based medicine meets recovery (2009) Community Ment Health J, 45 (5), pp. 323-332Onocko Campos, R.T., Campos, G.W., Ferrer, A.L., Correa, C.R., Madureira, P.R., Gama, C.A., Dantas, D.V., Nascimento, R., Evaluation of innovative strategies in the organization of primary health care (2012) Rev Saude Publica, 46 (1), pp. 43-50Goncalves, R.W., Vieira, F.S., Delgado, P.G., Mental health policy in brazil: Federal expenditure evolution between 2001 and 2009 (2012) Rev Saude Publica, 46 (1), pp. 51-58Bleger, J., (1984) Psico-higiene e psicologia institucional, , Porto Alegre: ArtMed EditoraFigueiró, R.A., Dimenstein, M., The daily life of users of CAPS: Empowerment or capture? (2010) Fractal: Rev. de Psicologia, 22 (2), pp. 431-446Carson, D., Good enough risk taking (1997) Int Rev Psychiatry, 9 (2-3), pp. 303-308Silva Melo, A.K., Godoy, M.G.C., Bosi, M.L.M., Ximenes, V.M., Carvalho, L.B., Inovação em saúde mental sob a ótica de usuários de um movimento comunitário no nordeste do brasil (2012) Cien Saude Colet, 17 (3), pp. 643-65