Longo caminho a percorrer na volta para a sociedade: o Ministério público e a desinstitucionalização em saúde mental

This dissertation aimed to analyze important aspects to monitor the process of deinstitutionalization, a central principle of National Mental Health Policy, by the Brazilian Public Prosecution Service. The objectives was to contribute to the consolidation of important elements of deinstitutionalization and to qualify the performance of the Brazilian Public Prosecution Service in mental health.The qualitative research consisted of literature and documental review, with systematic search for evidence which included 42 texts and 12 documents. The main elements of the deinstitutionalization captured from the literature and documentary analysis were categorized according to the four dimensions of the Psychiatric Reform defined by Paulo Amarante. The main elements found were: a) Epistemological Dimension: lifelong learning strategies and focused training for health professionals and Intersectorality; b) Legal-Political Dimension: health department management in the deinstitutionalization process; Regulation and financing; c) Socio-cultural dimension: Social participation d) Technical Assistance Dimension: Psychosocial Care Network; Therapeutic workshops; Therapeutic Project, Hospital Discharge and Therapeutic Monitoring. Each element has generated a number of aspects relevant to the monitoring. The epistemological and legal-political were important for the introduction and understanding of other dimensions, since they are the ones that support to the actions intended with the proposal of deinstitutionalization. The public class action analysis allowed a first approach of how the Brazilian Public Prosecution Service has been working in the deinstitutionalisation process. The results presented can be considered as an initial approach to the elaborative effort of constructing Public Health instruments to be used to qualify the performance of the Brazilian Public Prosecution Service in the deinstitutionalisation process.