Teresa Duarte (*)
RESUMO
Nos últimos anos, recovery emergiu como um novo paradigma na saúde mental. Com base nas narrativas das pessoas com experiência de doença mental e nos resultados de vários trabalhos de investigação, o recovery é uma experiência mais comum do que era tradicionalmente expectável e uma possibilidade real para as pessoas com doença mental.
O conceito de recovery tem sido proposto como visão orientadora na concepção e implementação de serviços e na definição de políticas públicas de saúde mental. Tendo em conta a influência que os contextos podem ter na promoção das oportunidades e dos processos de recovery das pessoas com experiência de doença mental, este artigo enuncia algumas estratégias para que os serviços e sistemas de saúde mental desenvolvem e integrem práticas mais consistentes com uma visão de recovery. Os serviços orientados para o recovery inscrevem-se num referencial de direitos humanos, adoptam uma abordagem acológica na sua análise dos problemas e estratégias de intervenção, desenvolvem uma cultura de esperança e empowerment, estabelecem uma relação colaborativa e de partilha de poder entre os vários stake-holders e promovem efectivamente a participação e integração social das pessoas com experiência de doença mental.
Palavras-chave: Recovery, pessoas com doença mental, serviços de saúde mental, participação e integração social, empowerment.
ABSTRACT
In the last years, recovery has emerged as a new paradigm in the mental health field. Based in the narratives of people with experience of mental illness and in several research studies, recovery has proved to be a more common experience that was traditionally expected and a real possibility for people with mental illness.
]]> The recovery concept was also introduced as the guiding vision for mental health services design and provision and for the system reform. Considering the contexts’ influence on promoting opportunities for recovery processes, this article presents some strategies that mental health services and systems should adopt and integrate in order to develop more recovery oriented practices. Recovery oriented services are based in an human rights framework, adopt an ecological approach in terms of analyses and intervention, develop a culture of hope and empowerment, establishes a collaborative and power sharing relationship between all the stakeholders and promotes the effective social integration of people with experience of mental illness.Key words: Recovery, people with experience of mental illness, mental health services, participation and social integration, empowerment.
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REFERÊNCIAS
Ahern, L., & Fisher, D. (1999). Personal Assistance in Community Existence: Recovery at Your Own Pace. Lawrence, MA: National Empowerment Center.
[ Links ]Anthony, W. (1993). Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal, 16 (4), 11-24.
Anthony, W. (2000). A recovery-oriented service system: setting some system level standards. Psychiatric Rehabilitation Journal, 24 (2), 159-168.
]]> Carling; P. (1995). Return to Community: Building Support Systems for People with Psychiatric Disabilities. New York: The Guilford Press.Chamberlin, J. (1997). A working definition of empowerment. Psychiatric Rehabilitation Journal, 20 (4), 43-46.
Chamberlin, J., & Rogers, J. (1990). Planning a community-based mental health system: Perspective of service recipients. American Psychologist, 45 (11), 1241-1244.
Chamberlin, J. (2006). Confessions of a Non-Compliant Patient. Consultado em 01/02/2006 em http://www.power2u.org.
Davidson, L., O’Connell, M., Tondora, J., Staeheli, M., & Evans, A. (2005). Recovery in serious mental illness. Paradigm shift or shibboleth. In L. Davidson,
C. Harding, & L. Spaniol (Eds.), Recovery from Severe Mental Illness: Research Evidence and Implications for Practice. Boston, MA: Center for Psychiatric Rehabilitation / Boston University.
Davidson, L., Sells, D., Sangster, S., & O’Connell, M. (2005). Qualitative studies of recovery: What can we learn from the person. In R. Ralph, & P. Corrigan (Eds.), Recovery in Mental Illness – Broadening our understanding of wellness. Washington, DC: American Psychological Association.
Deegan, P. (1988). Recovery: the lived experience of rehabilitation. Psychosocial Rehabilitation Journal, 11 (4), 11-19.
Deegan, P. (1999). Recovery, uma viagem do coração. In J. Ornelas (Coord.), Actas da Conferência Internacional – Novos Desafios na Reabilitação de Pessoas com Doença Mental (pp. 63-81). Lisboa: AEIPS Edições.
DeSisto, M., Harding, C., McCormick, R., Ashikaga, T., & Brooks, G. (1995). The Maine and Vermont three-decade studies of serious mental illness II: Longitudinal course comparisons. British Journal of Psychiatry, 167, 338-341.
]]> Farkas, M., Gagne, C., Anthony, W., & Chamberlin, J. (2005). A implementação de programas orientados para o recovery: Domínios cruciais. In J. Ornelas, F. Monteiro, M. Moniz, & T. Duarte (Coord.), Participação e Empowerment das Pessoas com Doença Mental e seus Familiares (pp. 19-43). Lisboa: AEIPS Edições.Fisher, D. (2006). A New Vision of Recovery: People can fully recover from mental illness. Consultado em 10/01/2006 em http://www.power2u.org.
Harding, C., Brooks, G., Ashikaga, T., Strauss, J., & Breier, A. (1987). The Vermont longitudinal study of persons with severe mental illness, II: Long-term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. American Journal of Psychiatry, 144, 727-735.
Jacobson, N., & Curtis, L. (2000). Recovery as policy in mental health services: Strategies emerging from the States. Psychiatric Rehabilitation Journal, 23 (4), 333-341.
Jacobson, N., & Greenley, D. (2001). What is recovery? A conceptual model and explication. Psychiatric Services, 52, 482-485.
Kloos, B. (2005). Creating new possibilities for promoting liberation, well-being and recovery: Learning from experiences of psychiatric consumers/survivors. In G. Nelson, & I. Prilleltensky (Eds.), Community Psychology: In Pursuit of Liberation and Well-Being. New York: Palgrave Macmillan.
Leete, E. (1989). How I perceive and manage my illness. Schizophrenia Bulletin, 8, 605-609.
Mead, S., & Copeland, M. H. (2000). What recovery means to us: Consumers’ perspectives. Community Health Journal, 36 (3), 315-328.
Nelson, G., Lord, J., & Ochocka, J. (2001). Shifting the Paradigm in Community Mental Health: Towards Empowerment and Community. Toronto: University of Toronto Press.
O’Connell, M., Tondora, J., Croog, G., Evans, A., & Davidson, L. (2005). From rhetoric to routine: assessing the perceptions of recovery-oriented practices in a state mental health and addiction system. Psychiatric Rehabilitation Journal, 28 (4), 378-386.
]]> Onken, S., Dumont, J., Ridgway, P., Dornan, D, & Ralph, R. (2002). Mental health recovery? What helps and what hinders? A national research project for the development of recovery facilitating system performance indicators. Alexandria, VA: National Association of State Mental Health Program Directors – National Technical Assistance Center.Ornelas, J. (2005). O modelo comunitário de intervenção em saúde mental na era pós-hospitalar. In J. Ornelas, F. Monteiro, M. Moniz, & T. Duarte (Coord.), Participação e Empowerment das Pessoas com Doença Mental e seus Familiares (pp. 19-43). Lisboa: AEIPS Edições.
Ralph, R. (2005). Verbal definitions and visual models of recovery: Focus on the recovery model. In R. Ralph, & P. Corrigan (Eds.), Recovery in Mental Illness – Broadening our understanding of wellness. Washington DC: American Psychological Association.
Stroul, B. (1986). Models of Community Support Services: Approaches to helping Persons with Long-Term Mental Illness. Boston, MA: Center for Psychiatric Rehabilitation / Boston University.
Trainor, J., Pomeroy, E., & Pape, B. (2004). A Framework for Support. Toronto: Canadian Mental Health Association/National Office.
(*) Associação para o Estudo e Integração Psicossocial. Instituto Superior de Psicologia Aplicada, Lisboa.
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