Contribuições de um Programa de Residência Multiprofissional em Saúde Mental para a formação de sujeitos críticos no campo da atenção psicossocial: Estudo de caso do programa de Residência Multiprofissional em Saúde Mental da UNIVASF.

Abstract

Multiprofessional residency training in Mental Health is immersed in the scenarios of teaching -service for professional qualification and theoretical-practical construction of psychosocial care. Studies observe a narrow relationship between residency programs and the National Policy on Continuing Education, especially, as understood that the main tool is education in work. This is a case study, with the objective of analyzing the contributions of a Multiprofessional Residency Program in Mental Health for the formation of critical subjects in the field of psychosocial care. The notion of “critical subjects” was worked, with the conceptualization of “transformational subjects” (Testa, 1997), subjects of praxis (Paim, 2017), instituting subjects (Nunes, 2015), in addition to the dialogue with the organizational support (Oliveira-Castro, Pilati e Borges Andrade, 1999; 2005). It involved the combination of technics such as interviews with key insiders and documental assistance given by the residency program. This research complied with the resolutions of the National Health Council 466/2012 and 510/2016. Based on the collected data, it was detailed the results and discussion by dimensions elaborated in an analytical matrix, based by the theoretical framework of the research. The study brought conceptions about Mental Health, brazilian psychiatric reform and psychosocial care, on the perspective of the subjects involved with the program. It analyzed elements of the training process, including pedagogical approach, teaching-service integration and contributions to the work in RAPS, as well as the constitution of critical subjects of the graduates, including aspects of organizational support to the work. The contributions of the program are pointed out by the conceptions of mental health articulated with assumptions of the brazilian psychiatric reform, presenting in its documents a conducive pedagogical and evaluative plan so the residents recognize this conception and practice it in their work. The training process and the relationship with work on RAPS showed higher density, in the idea of transposing formative aspects to the current work of the graduates. The contrasts of responses, associated with the diversity of the participants' fields of work, allowed the recognition of residency training by the graduates, the appreciation of the program in the dimension of learning by practice and the autonomy. The challenges in the articulation between training and field of work were discussed, pointing out gaps in the theoretical axes of the program, in the support with tutoring, difficulties in organizing the program at the university, among others. It was analyzed the close relationship of the constitution of critical subjects and the organizational support, concluding that there is a perception from the graduates of organizational support by managers, however, there are difficulties for teamwork and, availability to perform practices in the institutional collective. Transformations operated by the subjects were pointed out, in the organization of work and in the clinic of psychosocial care, from the perspective of the subjects of praxis (Paim, 2017), indicating the existence of instituting practices (Nunes, 2015), modifying the rigid structures of the services; were identified subjects with reflective and dialogic capability, politicalorganizational articulation and criticality to recognize competences, limits and contradictions. Common to the search for knowledge, other issues emerged, standing-out: the necessity of studies about the relationship between the psychosocial care team and the disputes of antagonistic care models; the work process in mental health teams and preceptorship training in this field.