Marcadores Psicossociais da Pessoa com transtorno mental em conflito com a lei pós (Des)Institucionalização realizada pela (EAP) de uma capital brasileira

Abstract

Criminal recidivism, homelessness and difficulty in accessing public policies are psychosocial markers found in deinstitutionalized people with mental disorders. The Reintegra project, created in 2019, is a joint partnership between the Judiciary, the Penitentiary System and Health Departments (SES) (SESAU), which includes the Service for the Assessment and Monitoring of Therapeutic Measures Applied to People with Mental Disorder in Conflict with the Law (EAP), aim to reduce the psychosocial problems of deinstitutionalization through individual and gradual planning and monitoring of the detention of prisoners, inserting them into the Psychosocial care network (RAPS), connecting them to the family support network and adapting their therapy according to the condition of the area legal. The research sought to describe the process of deinstitutionalization and the psychosocial markers of patients monitored by the Reintegra project, which includes the EAP of Campo Grande - MS. This is an cross-sectional study with a quantitative approach, being used for data collection: document analysis of the Singular Therapeutic Project, charts and reports produced by the EAP; and, the application of social interview through the Global Assessment of Functioning Scale (GFA) and the Questionnaire adapted for the study of housing for people with severe mental disorders. The sample had 41 patients followed up by the Reintegra project, already deinstitutionalized, and 31 (75.6%) agreed to participate in the research. The acceptance and signature of the Free and Clarified Term (TCLE) was divided between patients who were legally responsible for themselves 14 (45.1%) and those who were curated 17 (54.9%). The data collected are from different moments after the deinstitutionalization of the EAP and the patients were in different places of residence, with 20 (64.5%) being in residences, 6 (19.4%) in Therapeutic Residences (RT), 1 (3.2%) were waiting for a vacancy at the CAPS in (RT), 2 (6.5%) were institutionalized in private and permanent psychiatric hospitalizations at the family's option, and 2 (6.5%) returned to prison institutionalization due to criminal recidivism. The sociodemographic data consisted of users aged between 18 and 59 years, with a predominance of males 30 (96.8%), single 27 (87.1%), black or brown 19 (61.3%), who have 22 (70.9%) had not completed elementary school, 13 (41.9%) had never worked and 16 (51.6%) had up to 1 minimum wage as family income. As for the social markers of vulnerability and social insertion, 15 (48.4%) have access to social benefits, 24 (77.4%) have access to the Public Defender's Office, 8 (25.8%) have no bond or have a weakened bond with the support network, 15 (48.4%) reported a momentary homeless situation after leaving prison, however no patient was identified without a permanent fixed residence. The predominant mental disorders were behavioral due to the use of illicit Psychoactive Substances (SPA) and Schizophrenia and other psychoses, with the same result, 9 (29.0%) each. The diagnosis of 16 (51.6%) occurred after the prison institutionalization process. The average number of psychiatric hospitalizations since prison institutionalization was 6.06 per individual and 26 (83.9%) reported regular follow-up in the Psychosocial Health Care Network (RAPS) and prescribed medication use. The Global Functioning Assessment Scale (GFA) shows a predominance of patients with Severe Symptomatology 18 (58.1%), with scores between 20 and 50. It is concluded that patients assisted by the EAP's "Reintegra" project Campo Grande – MS, showed low psychosocial markers compared to national indicators.