“‘O que o bombeiro faz? O que ninguém mais faz’: uma etnografia sobre o atendimento de emergência à saúde mental realizado pelo Corpo de Bombeiros Militar da Paraíba”

Abstract

This thesis aims to understand the dynamics of emergency care for people in crisis situations in mental health provided by the Military Fire Brigade of Paraíba (CBMPB) in the metropolitan area of João Pessoa, in the post-Covid-19 pandemic context. The specific objectives include (i) analyzing how the concepts of crisis and emergency in mental health operate within the care dynamics, (ii) identifying the work processes of firefighter professionals, (iii) understanding how preparation for handling such cases occurs, and (iv) reflecting on the relationship of these professionals with other human and non-human elements involved in the care dynamics. Through ethnography conducted in two battalions in the capital of Paraíba and at two formative moments within the corporation, the research reveals that the care provided by CBMPB is based on an understanding of emergency linked to the ideas of limit-situation and risk management. The concept of crisis in mental health is incorporated into the understanding of emergency with the implementation of the Technical Approach to Suicide Attempts, which brought a humanizing perspective to both the person in distress and the firefighter in action, aligning the corporation's approach with a psychosocial understanding of the mental health field. Several work processes were identified, aimed at building physical, technical, and organizational readiness to provide the fastest response time and the capacity to deal with an endless number of possibilities in the here-and-now of the so-called "mental health occurrences," which involve the unpredictability of other mutual dynamics between humans, non-humans, service flows, and institutions. However, there are significant challenges in implementing a humanized approach for people in distress and active firefighters, particularly in cases involving crises such as psychosis, integration with emergency services, and the Psychosocial Care Network, as well as regarding the mental health of the firefighters themselves. Processes of suffering were identified related to work experiences and the lack of emotional readiness development and institutional mental health policies for the corporation's workers. Thus, this thesis contributes to expanding discussions on the interface between mental health, emergency services, and public safety, highlighting the challenges and possibilities for building care aligned with the Brazilian Psychiatric Reform.