[Neo-institutionalization in the context of psychiatric reform: an analysis of the trajectory of Psychosocial Care Center (PCC) users].

Abstract

Deinstitutionalization enables the removal of users from asylums with the support of the Psychosocial Care Network (PCN), which is based on the Psychosocial Care Centers (PCCs). One of the current impasses is the emergence of private/religious institutions that are updating the asylum model. In order to analyze what leads to neo-institutionalization in these locations, an ethnographical study was carried out on nine cases in four PCCs of the three PCNs in the city of Rio de Janeiro, through scrutiny of medical records, interviews with the patient, family members, PCC technicians and managers of the asylums per se. These locations were institutionalized despite the support of the PCCs and were selected for the research due to the diversity of characteristics, territories and institutional destinations that permitted investigation. The conclusion drawn is that neo-institutionalization is motivated by different factors: crisis, asylum concept, disarticulation and precariousness of intra- and intersectoral networks, reduced teams and insufficient number of territorial services, institutionalization of PCCs, low crisis reception capacity, family overload and family expectations, lack of regular support for family members and housing projects for users whose caregivers have died, are elderly or become ill.