Repercussões pandêmicas no fazer, ser e futuro de Centros de Atenção Psicossocial

Abstract

The Psychosocial Care Centers (CAPS) are mental health services that focus on the user's care in social reintegration, comprehensive, humane, territorial, and open approaches. In March 2020, a global health emergency was declared due to the outbreak of the new coronavirus, COVID-19, which required the adaptation of society and services urgently as it devastated lives and triggered new social and economic crises. CAPS were not exempt from this scenario, seeking to develop measures to adjust to a new way of providing care and functioning, in alignment with the usual strategies of these services, both in facing challenges resulting from the pandemic and in post-pandemic reconstruction. The questions that arise are: How did the pandemic impact the care provided by CAPS? What are the possible implications for the future of these services? Research on these impacts can help understand the period experienced by analyzing the coping strategies adopted and the remaining constraints for promoting new parameters for service reorganization. Thus, the objectives of this study are to describe the repercussions of the pandemic on the care offered by CAPS during the pandemic and to understand the implications of the pandemic for the continuity of CAPS services after the pandemic; these objectives are addressed in studies 1 and 2, respectively. This is a qualitative research with a phenomenological framework and analysis based on the assumptions of psychiatric reform and updated scientific literature.The research site was a city in the interior of Minas Gerais, Brazil, with four CAPS (2 adult, 1 Alcohol and Other Drugs (AOD III), 1 child and adolescent) involving twelve professionals from these services. They responded to an online questionnaire and provided semi-structured interviews. The research was approved by the Research Ethics Committee. In study 1, the main results indicated that the initial moments of the pandemic were experienced with fear and innovation in adaptations, which continued throughout the pandemic. The return to in-person services required new protocols and exposed the overcrowding of services, already facing reduced teams, thus increasing the workload on professionals. The results are consistent with situations experienced in other contexts and indicate pre-existing problems that were exacerbated by the pandemic. Principles such as social reintegration and territorialization that govern the service were also affected, along with an intensification of societal views on the process of exclusion and the strengthening of medicalization strategies. In study 2, the results indicated that the pandemic left marks that need to be addressed in the continuity of services. These are related to the health of the workers and the exacerbation of pre-existing difficulties, such as social and economic problems experienced by service users. Professionals were responsible for maintaining CAPS, and the workload, support, and recognition generated ethical dilemmas, illnesses, and a duality in expectations regarding the future of the services.The studies conclude that the pandemic has had an impact on the way CAPS operate, and challenges related to the essence of psychosocial services need to be addressed for their strengthening. Thus, CAPS emerge as places of resistance and struggle, often sustained by professionals in line with their creation; these actors need to be under the lens of care and recognition.