Chronicity in mental health: A look at Brazilian scientific production

Abstract

The aim of this article was to analyze the conceptions regarding chronicity in mental health in the field of the Brazilian psychiatric reform and psychosocial rehabilitation. An integrative review of Brazilian contemporary scientific production was carried out considering this theme. As a result, it can be seen how, for literature, chronicity is predominantly determined by institutionalization and specific care practices for psychic suffering and crises, which include: the permanence of the mental hospital model of guardianship and isolation practices (hospital readmissions, leading to the impermanence of the subject in the territory); assistance based on psychiatric diagnoses and medicines and not on individual’s singularity; care fragmentation. Some authors have even portrayed a new kind of chronicity, with features such as the ‘revolving door’ and permanent attachment to outpatient clinics, as evidence of the failure of reformed psychiatry’s intentions. Overcoming the reproduction of mental health chronicity, according to literature, involves territorialized networking, intersectoral and demedicalizing assistance, in order to ensure follow-up integrality and freedom. It is worth highlighting the negligible presence, in the articles, of reflections on other non-assistance determinations of permanent psychic suffering, such as living and work conditions transformations, and insertion in certain communities (social class, professional categories, gender, ethnicity/race etc.).