Brazilian Psychiatric Reform as a struggle for recognition: the process of obtaining / denying the benefit of continued provision of people in psychological distress
Fight for recognition. Deinstitutionalization. Brazilian Psychiatric Reform. Continued Installment Benefit. Psychic Suffering.
The general objective of this thesis was to understand the normative standards of recognition that modulate the access to social protection rights (BPC) of people in psychological distress in Salvador (BA), as well as to identify the areas of moral conflicts silenced in this process. For that, we start from the experiences of disrespect that hurt the expectations of the users' recognition and we follow them through the different institutional instances (Communitary Mental Health Services CAPS, Social Security National Institute INSS, Federal Justice).
To fulfill this objective, we carried out a work of articulation and conceptual elaboration between the theory of recognition, the paradigm of deinstitutionalization and the Brasilian Psychiatric Reform (RPB). We also used a methodological approach that included unstructured interviews with users and professionals who participate in the BPC process, as well as participant observation in the ethnographic context and documentary analysis (CAPS medical records and reports; INSS instrument; and JF expert reports).
For data analysis we used a hermeneutic approach and the results were presented in two chapters. In the first one, “The misery of the world and the infamous fighters”, following the direction of a sociology of absences and emergencies, we have recovered a fundamental chapter in the social life of our subjects, deficitly recognized by the contribution / benefit polarity. And in the second, “The generalized Other of madness in social assistance”, we present a detailed analysis of the moral grammar of recognition and the silenced conflicts that run through all the institutional instances involved in the BPC process.
From the analysis of silenced moral conflicts and the feelings of injustice experienced by many subjects (users and professionals), it was possible to characterize the intersubjective structure and the socio-structural conditions of recognition pointed out as social pathology. But also, the needs, pretensions, values and ideas of justice from which to develop alternative normative-practical and institutional directions. Finally, subsidies to renew the motivational source of the struggles for the recognition and social inclusion of people in psychological suffering.