A rede psicossocial e a adolescência institucionalizada e medicalizada: uma análise psicanalítica sobre os impasses na produção do cuidado

Abstract

This research aims to reflect on the current psychosocial care practices developed in institutional shelter services in a city in the state of Minas Gerais, focusing on the medicalizing processes that affect adolescents served by these services. The medicalization of children and adolescents has been widely discussed in the Brazilian context, with emphasis on the interface between health and education. A less explored yet equally relevant field regarding the presence and effects of medicalization processes is the field of social assistance policies. Medicalization is a polysemic phenomenon, whose definition varies according to the different epistemological approaches that analyze it. In general, it is characterized as the process of transforming experiences considered undesirable or disturbing into objects of health, shifting political, social, cultural, and affective issues into the domain of the medical order and related practices, pathologizing them. Based on the psychoanalytic method, this research is characterized as a production in implicated psychoanalysis. The topic was approached through the psychoanalytic listening of 14 workers who are part of the reference teams of protective measures involving institutional and family care in a medium-sized city in Minas Gerais. The study included professionals from two institutional shelter services, one foster care service, and a mentorship program. The analysis addressed the multiple dimensions of medicalization operating in the shelter units, such as: the framing of youth suffering through psychiatric diagnoses; widespread prescription of psychotropic drugs; imposition of institutional trajectories; and psychiatric hospitalization. Furthermore, it was found that the institutions had fragile resources to sustain care, which directly impacted the quality of service. Finally, it is understood that only collective articulation can point toward the creation of alternatives to medicalizing circuits—alternatives that are sociopolitically engaged. Care is thus understood as a process of becoming, in constant elaboration, and the result of collective production.