Antonio Miguel Bañón Hernández

Trabalhadores em saúde mental: contradições e desafios no contexto da reforma psiquiátrica

Resumen Este estudio analiza el discurso de trabajadores, señalando caminos, dudas e incertidumbres que se presentan en el proceso de constitución del equipo de una institución de servicios comunitarios de salud mental. El corpus se compone de entrevistas aplicadas en el año de 2006 a 17 de los 25 profesionales de salud mental que trabajan en un servicio sustitutivo de una ciudad de la Región Sur de Brasil. El dispositivo metodológico que subsidia la sistematización de los datos es el “diagrama axiológico-discursivo”, construido a partir de los presupuestos teóricos del Análisis Crítico del Discurso. Se constató que la incertidumbre operacional que une y fragmenta, al mismo tiempo, el equipo está relacionao con una gran variedad de posibilidades, que empieza en la indefinición operacional de los objetos e instrumentos de trabajo en el área de la salud mental, y termina en la dificultad de identificar quienes son los profesionales que deben cuidar de la locura en el servicio. Se espera que este estudio pueda ayudar en la problematización del movimiento de reforma psiquiátrica en el contexto brasileño. Palabras-Clave: Salud mental. Reforma de los servicios de salud. Políticas de salud Professor Adjunto da Faculdade de Enfermagem e Obstetrícia da Universidade Federal de Pelotas (Brasil). Doutor em Enfermagem Psiquiátrica pela EERP-USP. Brasil. E-mail: Lbpinho@uol.com.br, Professor Titular do Depar tamento de Filologia da Universidade de Almería (Espanha). Doutor em Filologia e Líder do Grupo de Pesquisa ECCO (Estudios Críticos sobre la Comunicación)Espanha. E-mail: amhernan@ual.es, Professora Adjunta da Faculdade de Enfermagem e Obstetrícia da Universidade Federal de Pelotas (Brasil). Doutora em Enfermagem. Pesquisadora do CNPq. Brasil. E-mail: kantorski@uol.com.br ESQUISA RESEARCH INVESTIGACIÓN This study analyzes the mental health workers discourse, pointing directions, doubts and uncertainties about the formation of the community mental health service team. The corpus consists in interviews applied in 2006 to 17 of 25 mental health workers in a substitutive service in a city in southern Brazil. The methodological device which subsidizes the systematization of the data is the “axiological-discursive diagram”, constructed from the Critical Discourse Analysis theoretical framework. It was found that the operational uncertainty that joins the team and its fragments at the same time, is related to a cascade of possibilities, which began operating in the very vagueness of the objects and instruments of work in mental health and ending on the difficulty of identifying who are the professionals who must take care of madness in the service. We hope this study can help in questioning the movement of psychiatric reform in the Brazilian context.

Critical discourse analysis: new possibilities for scientific research in the mental health area

The present study aims to get to know the philosophical, conceptual and methodological aspects of Critical Discourse Analysis, as a theoretical-methodological framework for research in the mental health area. Initially, the study presents a reflection on psychiatric discourse in history and at present, with the goal of introducing concepts and presuppositions that would guide the analysis of discursive processes. Discussions are presented about the historical milestones of Critical Discourse Analysis as an analytical framework in social sciences. Finally, the study presents its conceptual and methodological applications to research in the mental health area.The present study aims to get to know the philosophical, conceptual and methodological aspects of Critical Discourse Analysis, as a theoretical-methodological framework for research in the mental health area. Initially, the study presents a reflection on psychiatric discourse in history and at present, with the goal of introducing concepts and presuppositions that would guide the analysis of discursive processes. Discussions are presented about the historical milestones of Critical Discourse Analysis as an analytical framework in social sciences. Finally, the study presents its conceptual and methodological applications to research in the mental health area.

Análise crítica do discurso: novas possibilidades para a investigação científica no campo da saúde mental

The present study aims to get to know the philosophical, conceptual and methodological aspects of Critical Discourse Analysis, as a theoretical-methodological framework for research in the mental health area. Initially, the study presents a reflection on psychiatric discourse in history and at present, with the goal of introducing concepts and presuppositions that would guide the analysis of discursive processes. Discussions are presented about the historical milestones of Critical Discourse Analysis as an analytical framework in social sciences. Finally, the study presents its conceptual and methodological applications to research in the mental health area.The present study aims to get to know the philosophical, conceptual and methodological aspects of Critical Discourse Analysis, as a theoretical-methodological framework for research in the mental health area. Initially, the study presents a reflection on psychiatric discourse in history and at present, with the goal of introducing concepts and presuppositions that would guide the analysis of discursive processes. Discussions are presented about the historical milestones of Critical Discourse Analysis as an analytical framework in social sciences. Finally, the study presents its conceptual and methodological applications to research in the mental health area.

Ánimo. Estamos con vosotros: Messages of solidarity written in a visitors’ book during a sit-in conducted by a group of immigrants in Spain:

We are experiencing a time during which there is a clear crisis of values, meaning a distancing with regard to the problems of socially disadvantaged groups. This article’s main purpose is to discuss whether this situation has had any impact on solidarity discourse towards immigrants. To fulfill our objective, we will analyse the written messages in a visitors’ book used for a sit-in that took place in Murcia, Spain, in 2001. We selected 100 of these messages to determine the degree of involvement that visitors show towards immigrants. In this regard, we have proposed four processes of involvement, from low to high: proximity, accompaniment, support and identification. We will analyse these processes from a critical and constructive viewpoint in an attempt to determine which is the most common and which combinations of processes are preferred by the authors of the messages. In addition, we will focus on the use of key expressions, terms of intensification, and argumentative structures as basic elements for the interpretation of these processes of involvement.

Cómo recuerdan los pacientes la comunicación del diagnóstico. A propósito de quince testimonios relacionados con enfermedades poco frecuentes

Abstract: Doctor-patient communication has led, in recent years, great interest among the health community. Communicating the diagnosis is one of the key moments for people suffering an illness. In this paper, we will analyze 15 testimonies of people and families affected by a rare disease. We will observe how they remember the moment when they were told the diagnosis, paying close attention to the discourse processes and techniques related to space (representing direction, itinerary and speed) and the use of other relevant discourse strategies (communication accommodation). _______________________________________________________________________________________________________ Resumen: La comunicacion medico-paciente ha suscitado, en los ultimos anos, gran interes entre la comunidad sanitaria. La comunicacion del diagnostico es uno de los momentos mas importantes para las personas que sufren una enfermedad. En este trabajo vamos a analizar 15 testimonios de personas y familiares de afectados por una enfermedad rara o poco frecuente. Observaremos como recuerdan el momento en el que les comunicaron el diagnostico, prestando maxima atencion a los procesos y tecnicas discursivas relacionadas con el espacio (representacion de la direccion, del recorrido y de la velocidad), asi como al empleo de otras tecnicas discursivas (acomodacion comunicativa).

Mental health workers': contradictions and challenges in the psychiatric reform context

Resumen Este estudio analiza el discurso de trabajadores, señalando caminos, dudas e incertidumbres que se presentan en el proceso de constitución del equipo de una institución de servicios comunitarios de salud mental. El corpus se compone de entrevistas aplicadas en el año de 2006 a 17 de los 25 profesionales de salud mental que trabajan en un servicio sustitutivo de una ciudad de la Región Sur de Brasil. El dispositivo metodológico que subsidia la sistematización de los datos es el “diagrama axiológico-discursivo”, construido a partir de los presupuestos teóricos del Análisis Crítico del Discurso. Se constató que la incertidumbre operacional que une y fragmenta, al mismo tiempo, el equipo está relacionao con una gran variedad de posibilidades, que empieza en la indefinición operacional de los objetos e instrumentos de trabajo en el área de la salud mental, y termina en la dificultad de identificar quienes son los profesionales que deben cuidar de la locura en el servicio. Se espera que este estudio pueda ayudar en la problematización del movimiento de reforma psiquiátrica en el contexto brasileño. Palabras-Clave: Salud mental. Reforma de los servicios de salud. Políticas de salud Professor Adjunto da Faculdade de Enfermagem e Obstetrícia da Universidade Federal de Pelotas (Brasil). Doutor em Enfermagem Psiquiátrica pela EERP-USP. Brasil. E-mail: Lbpinho@uol.com.br, Professor Titular do Depar tamento de Filologia da Universidade de Almería (Espanha). Doutor em Filologia e Líder do Grupo de Pesquisa ECCO (Estudios Críticos sobre la Comunicación)Espanha. E-mail: amhernan@ual.es, Professora Adjunta da Faculdade de Enfermagem e Obstetrícia da Universidade Federal de Pelotas (Brasil). Doutora em Enfermagem. Pesquisadora do CNPq. Brasil. E-mail: kantorski@uol.com.br ESQUISA RESEARCH INVESTIGACIÓN This study analyzes the mental health workers discourse, pointing directions, doubts and uncertainties about the formation of the community mental health service team. The corpus consists in interviews applied in 2006 to 17 of 25 mental health workers in a substitutive service in a city in southern Brazil. The methodological device which subsidizes the systematization of the data is the “axiological-discursive diagram”, constructed from the Critical Discourse Analysis theoretical framework. It was found that the operational uncertainty that joins the team and its fragments at the same time, is related to a cascade of possibilities, which began operating in the very vagueness of the objects and instruments of work in mental health and ending on the difficulty of identifying who are the professionals who must take care of madness in the service. We hope this study can help in questioning the movement of psychiatric reform in the Brazilian context.

Trabajadores del área de salud mental: contradicciones y desafíos en el contexto de la reforma psiquiátrica

Resumen Este estudio analiza el discurso de trabajadores, señalando caminos, dudas e incertidumbres que se presentan en el proceso de constitución del equipo de una institución de servicios comunitarios de salud mental. El corpus se compone de entrevistas aplicadas en el año de 2006 a 17 de los 25 profesionales de salud mental que trabajan en un servicio sustitutivo de una ciudad de la Región Sur de Brasil. El dispositivo metodológico que subsidia la sistematización de los datos es el “diagrama axiológico-discursivo”, construido a partir de los presupuestos teóricos del Análisis Crítico del Discurso. Se constató que la incertidumbre operacional que une y fragmenta, al mismo tiempo, el equipo está relacionao con una gran variedad de posibilidades, que empieza en la indefinición operacional de los objetos e instrumentos de trabajo en el área de la salud mental, y termina en la dificultad de identificar quienes son los profesionales que deben cuidar de la locura en el servicio. Se espera que este estudio pueda ayudar en la problematización del movimiento de reforma psiquiátrica en el contexto brasileño. Palabras-Clave: Salud mental. Reforma de los servicios de salud. Políticas de salud Professor Adjunto da Faculdade de Enfermagem e Obstetrícia da Universidade Federal de Pelotas (Brasil). Doutor em Enfermagem Psiquiátrica pela EERP-USP. Brasil. E-mail: Lbpinho@uol.com.br, Professor Titular do Depar tamento de Filologia da Universidade de Almería (Espanha). Doutor em Filologia e Líder do Grupo de Pesquisa ECCO (Estudios Críticos sobre la Comunicación)Espanha. E-mail: amhernan@ual.es, Professora Adjunta da Faculdade de Enfermagem e Obstetrícia da Universidade Federal de Pelotas (Brasil). Doutora em Enfermagem. Pesquisadora do CNPq. Brasil. E-mail: kantorski@uol.com.br ESQUISA RESEARCH INVESTIGACIÓN This study analyzes the mental health workers discourse, pointing directions, doubts and uncertainties about the formation of the community mental health service team. The corpus consists in interviews applied in 2006 to 17 of 25 mental health workers in a substitutive service in a city in southern Brazil. The methodological device which subsidizes the systematization of the data is the “axiological-discursive diagram”, constructed from the Critical Discourse Analysis theoretical framework. It was found that the operational uncertainty that joins the team and its fragments at the same time, is related to a cascade of possibilities, which began operating in the very vagueness of the objects and instruments of work in mental health and ending on the difficulty of identifying who are the professionals who must take care of madness in the service. We hope this study can help in questioning the movement of psychiatric reform in the Brazilian context.

Análisis crítico del discurso: nuevas posibilidades para la investigación científica en el campo de la salud mental

The present study aims to get to know the philosophical, conceptual and methodological aspects of Critical Discourse Analysis, as a theoretical-methodological framework for research in the mental health area. Initially, the study presents a reflection on psychiatric discourse in history and at present, with the goal of introducing concepts and presuppositions that would guide the analysis of discursive processes. Discussions are presented about the historical milestones of Critical Discourse Analysis as an analytical framework in social sciences. Finally, the study presents its conceptual and methodological applications to research in the mental health area.The present study aims to get to know the philosophical, conceptual and methodological aspects of Critical Discourse Analysis, as a theoretical-methodological framework for research in the mental health area. Initially, the study presents a reflection on psychiatric discourse in history and at present, with the goal of introducing concepts and presuppositions that would guide the analysis of discursive processes. Discussions are presented about the historical milestones of Critical Discourse Analysis as an analytical framework in social sciences. Finally, the study presents its conceptual and methodological applications to research in the mental health area.