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Lived itineraries, narrated stories: the autonomy gradients among beneficiaries of the ‘Back Home Program’

ABSTRACT

This work starts from a multicenter research that covers eleven cities that suffered federal intervention to close their psychiatric hospitals and have used the ‘De Volta para Casa’ Program (PVC – Back Home Program) as a deinstitutionalization strategy. Methodologically inspired by ethnography and life history methodology, we followed the itinerary of the first beneficiaries of PVC in a city in Paraíba, and from participant observation and direct exchanges with them, we produced narratives guided by four axes of analysis: 1) Life Trajectory; 2) Autonomy: emancipation x oppression; 3) What capital provides; 4) Access to health, access to life. Our goal was to understand the effects of this rehabilitation aid on the reconstruction of beneficiaries’ autonomy, in its different degrees. Understanding autonomy as the subject’s ability to build bonds with other people and deal with his dependency network, we present different degrees of autonomy expressed by PVC beneficiaries, starting from the centrality of the concept and the tension that it causes. It was noted that there are many ways and degrees of autonomy, which testifies against the hegemonic liberal view of autonomy.

KEYWORDS
Personal autonomy; Health care reform; Deinstitutionalization

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