Therapeutic relationships and care in addressing vulnerability in the psychiatric revolving-door phenomenonObjective: To analyze therapeutic relationships in psychosocial care and their role in addressing the vulnerability of people involved in the revolving door phenomenon.
Method: A qualitative case study, grounded in historical-dialectical materialism, was conducted in health and social assistance services in southern Brazil between March and August 2023. Participants included eight patients over 18 years of age, all with at least two psychiatric hospitalizations between 2021 and 2023. Data collection included guided discursive interviews, information from the hospitalization system, and field notes. Data were analyzed, supported by NVivo® 14, in stages: segmentation, qualification, and individuation.
Results: The narratives revealed multiple vulnerabilities: individual (severe mental disorders, problematic substance use, low therapeutic adherence), social (unemployment, family breakdown, precarious housing), and programmatic (weaknesses in the care network, limited access to social assistance). It was evident that experiences of integration between Psychosocial Care Centers and social assistance services provide concrete alternatives to rehospitalization, such as access to benefits, housing support, rights mediation, and community strengthening.
Final considerations: Therapeutic relationships, guided by acceptance, shared responsibility, community support, and the guarantee of rights, constitute essential technology for the continuity of care in freedom and the confrontation of vulnerability.
Descriptors:
Mental health; Social vulnerability; Social support; Social work; Psychiatric nursing