FROM THE MAINA RIVER HEALTH CENTER TO THE THERAPEUTIC RESIDENTIAL SERVICE: THE DEACREDITATION OF PSYCHIATRIC BEDS AND THE ONGOING DEINSTITUTIONALIZATION PROCESSTÍTULO DO TRABALHO EM INGLÊS

Abstract

The Brazilian Psychiatric Reform is a complex political and social process aimed at transforming the traditional psychiatric model into a psychosocial care model, progressing through legal and political frameworks to enable the closure of psychiatric hospitals. For individuals with a history of long-term psychiatric hospitalization who, due to the sequelae of institutionalization, are faced with the concrete reality of no longer having a place to live, the Unified Health System (SUS) created the Therapeutic Residential Service—a space that serves as permanent housing for these individuals. In this context, the present article aims to understand how the deinstitutionalization and psychosocial rehabilitation process took place for long-stay residents of the Casa de Saúde do Rio Maina, a psychiatric hospital formerly located in Criciúma, Santa Catarina. The study adopted an exploratory and descriptive participatory research design with a qualitative approach. It employed self-narratives and discourse analysis as research tools, with data analysis grounded in Laurence Bardin’s content analysis framework. Four interviews were conducted using the snowball sampling technique. The results were organized into two thematic categories. The first, “The scenario from 2010 to 2013: the instruments of the Brazilian Psychiatric Reform, residents' living conditions, and the initial attempt at deinstitutionalization,” outlines the first attempt to deinstitutionalize the residents of the Casa de Saúde do Rio Maina and describes the prevailing context and conditions at that time. The second category, titled “The scenario from 2017 to the present: the decommissioning of psychiatric beds, the closure of the Rio Maina Psychiatric Hospital, deinstitutionalization, and psychosocial rehabilitation,” discusses how the progress of the Brazilian Psychiatric Reform contributed to the closure of the hospital, the relocation of former residents to new homes, and debates whether true deinstitutionalization and psychosocial rehabilitation were achieved. The study concludes that deinstitutionalization is not merely about shutting down asylums, but about opening new pathways that enable the reimagining of a society more deeply connected to its diversity.