Processo de trabalho dos Centros de Atenção Psicossocial III de João Pessoa-PB na perspectiva dos trabalhadores

Abstract

The Psychosocial Care Centers (CAPS) are strategic devices of the Psychosocial Care Network (RAPS), inserted in the logic of the Psychiatric Reform in Brazil, which aims to replace the asylum model with community and territorialized services. In recent years, they have been facing significant challenges, due to insufficient and discontinued policies that have caused a series of difficulties in providing care and assistance to people with mental disorders. In this context, investigating the work process in CAPS is relevant, as it is capable of instigating debates and decision-making for daily practices and mental health care policies. This study aims to analyze the work process in CAPS type III in the city of João Pessoa, from the perspective of professionals. This is a descriptive study using a mixed approach, with workers who work directly in the care of CAPS III in the capital of Paraíba. The professionals answered a questionnaire providing general and sociodemographic information, and participated in individual interviews during working hours. The interview followed a semi-structured script composed of eight themes: users' rights, family, work relationships, unique therapeutic project, activities and workshops, medication use, crisis care and continuing education. We used the analysis of Lefèvre's Collective Subject Discourse to analyze the quali-quanti data from the interviews, and descriptive statistics to characterize the professionals.21 professionals participated, with a predominance of women, self-declared white, aged between 30 and 39 years old, social workers and psychologists, hired on an on-call basis and with work experience at CAPS between two and seven years. The following categories of analysis were found: practices in groups as a producer of autonomy, difficulties of intersectorality in managing the users' crisis and the singular therapeutic project from the perspective of the CAPS professional.It was observed that the work process at CAPS III in João Pessoa is characterized by a multidisciplinary team, with limited integration and made difficult by the distance from the medical category, ideological disputes and weaknesses in communication between night and day teams. Autonomy is stimulated mainly through group practices of music, art and income generation, physical exercise in the territory and psychoeducation for users and their families. Intersectorality has been compromised especially during the management of intense crises, with difficulties in reaching agreements between CAPS, SAMU and Emergency Mental Health Care.There are different conceptions of a singular therapeutic project from the perspective of the CAPS professional, often limited to the inclusion of users in therapeutic workshops, impacting the full comprehensiveness of care. It was concluded that there are advances in work processes in relation to the traditional asylum model, but subjective and structural challenges persist in CAPS, which compromise team integration, full user autonomy, intersectoral coordination in crisis management and a construction effectiveness of the unique therapeutic project to promote comprehensive mental health care.