A atenção à crise nos centros de atenção psicossocial infantojuvenis

Abstract

Attention to the crisis is one of the main objectives of the CAPS service, besides one of greatest challenges of Brazilian Psychiatric Reform. Crisis is a complex experience, which involves not only the subject in psychic suffering, but their contexts of life and social relations. Seeking to understand how this care has been offered to child and youth population, this study aimed to identify which strategies on care for crisis situations are offered by the CAPSij teams, in addition to understanding the demands and daily life of families and adolescents experiencing crisis situations. This is a qualitative and exploratory study, in which a questionnaire for managers and a semi-structured interview guide for family members were used for data collection. Participated in the study six managers and twelve family members of children or adolescents associated to six CAPSij from a particular region of São Paulo city. For the analysis of questionnaires data was used categorization stage of Content Analysis technique and for interviews data Collective Subject Discourse method. The results indicate that the majority of adolescents experience several crises and hospitalizations, with a routine restricted to the house, the CAPSij and the school, for those who attend it. Besides, they exhibit a significant limitation in social relations. Relatives mean crises as an incomprehensible and unpredictable phenomenon and demonstrate an experience marked by intense suffering and important impacts on their daily lives. In relation to the crisis conceptions presented by the teams, there is a tendency towards a psychosocial conception, recognizing the inseparability between the singular and collective dimensions of the crisis. On the other hand, aspects of psychiatric conception are still present in the discourse of the teams, relating the crisis to causing acute symptoms. Among the main care strategies offered by CAPSij in crisis situations are the immediate reception to the user, daytime reception, family support, referrals to the network, intensification of the singular therapeutic project and team's evaluation and intervention. These results reinforce the extent to which crisis situations require immediate care actions and point out the importance of investing in the bond and therapeutic relationship as the main working tools in this field. The CAPSij have been presented as an important support to families, but the results also reveal gaps for more effective care, such as operating hours of the CAPSij II and absence of a hospital rear in RAPS for children and adolescents. Among the main equipments activated by the teams, in crisis situations, are the CAPSij III and General Hospitals. The CAPSij III is presented in this study as a powerful strategy to reception of crisis of children and adolescents, enabling more humanized interventions and avoiding hospitalizations. It is pointed out the need for greater attention to the families and involvement in territorial actions as fundamental care strategies for crisis situations. Also, it is is emphasized the demand for the expansion of investments in CAPSij, as well as in all points of the RAPS in order to guarantee improvements in attention to crisis of children and adolescents, being of extreme urgency the problematization of these issues in the public policies of mental health to population.