A clínica ampliada na saúde mental: que história é essa?.

Abstract

This study presents a history of the expanded clinic, in relation to care practices in the field of Collective Mental Health in Brazil. The emergence of the expanded clinic, as an area of knowledge, is located at the interface between Mental Health and Primary Care. The reconstructed history, in the present dissertation, was presented through an archeogenealogy, demarcating of the historical and epistemological conditions so that the expanded clinic has become a device in Mental Health, from which it articulates care practices in this field. As specific objectives, the research carried out identifies the conditions of historical appearance and transformations of the expanded clinic as a device in the field of mental health; explains the breaking points with other discourses that guide the clinic, describes the discursive plot that characterizes the expanded clinic as a care device and analyzes the extent to which the expanded clinic establishes correlations with other clinical discourses in the context of psychosocial care. The strategies used were literature review, documentary analysis and thematic and unstructured interview, through Oral History. The analysis of the material produced was carried out based on operations for an archaeological analysis, identifying the relationships contained among discursive and non-discursive elements, based on the reference of The Archaeology of Knowledge. The results point to the analysis that the support of the expanded clinic presents itself as a challenge, to the extent that it is born as a device of counterpower, institutionalized and today, in undemocratic times, has its place threatened by an evidence-based clinic and in protocol procedures. In that sense, it may become a strategy for confronting and resisting the current scenario of degradation of the Unified Health System and for the return of asylum proposals associated with setbacks and hard blows to work in the Brazilian Public Health, as in being able to reinvent itself collectively and reposition in the face the power relations that are established nowadays.