The work in the management of mental health substitutive services: between Collective Health, Mental Health and Psychoanalysis



The objective is to investigate the interrelationships between the fields of Collective Health, Mental Health and Psychoanalysis in the management of mental health services in the context of the Unified Health System. This is a qualitative research carried out in four municipalities of the state of Rio Grande do Sul, Brazil, with six managers of mental health services identified with psychoanalysis. The instruments of data collection employed were a personal and sociodemographic data sheet and a semi-structured interview. Thematic analysis was used to analyze the data, resulting in the identification of three central themes: 1) Training and experience in management and in Collective Health; 2) Manicomial logic versus reformist logic: challenges to manage it; and 3) Psychoanalysis: between contributions and limits. The results point out the difficulties and the challenges to manage it in the face of the coexistence in the services of different logics of mental health care. Psychoanalysis is assumed as an ethical-political positioning based on the listening of the subjects' unconscious processes, which occur in the transferential field, contributing in the support to the understanding of the cases and in the management of relational and institutional aspects. On the other hand, there is a need to bring psychoanalysis closer to the context of mental health.

psychiatric reform; psychoanalysis; health management; health manager; mental health services

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