Un siglo de asistencia en el Hospício Nacional de Alienados do Rio de Janeiro, 1852-1944 / A century of assistance at the Hospicio Nacional de Alienados of Rio de Janeiro, 1852-1944

Este libro nos imbuye de una reflexión historiográfica que abarca la historia institucional, la historia de los saberes y las prácticas psiquiátricas, pero también la historia de personas, no solo del personal sanitario, sino de pacientes con una historia hecha "desde abajo" que abre la mirada de la subjetividad. Sin duda, esta investigación fomenta la preservación del acervo del HNA que pertenece a cuatro instituciones: Instituto Municipal de Assistência à Saúde Nise da Silveira, Instituto Municipal de Assistência à Saúde Juliano Moreira, Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro y Museu Penitenciário do Estado do Rio Janeiro. No podemos finalizar sin señalar que este volumen no solo puede interesar al público especializado en antropología, sociología, historia de la psicología o psiquiatría, entre otras disciplinas, sino también es idóneo para un público universitario más joven. El conjunto resulta muy rico en abordajes de modo que su lectura da claves para la utilización de los archivos y el manejo de fuentes y bibliografía secundaria a aquellas personas que se adentren en sus primeras investigaciones, tesis de maestría o doctorado, una cualidad que se debe a su coordinadora y coordinador.

[Classifying the women: psychiatric diagnoses and female subjectivity in the Manicomio Provincial de Málaga, Spain, 1909-1950]. / Clasificando mujeres: diagnósticos psiquiátricos y subjetividad femenina en el Manicomio Provincial de Málaga, España, 1909-1950.

The clinical histories of women's asylums allow us to deepen the gap between the positivist illusion of psychiatry during the first half of the 20th century in Spain and the subjective experience of the psychiatric internment of doubly subaltern crazy women. Diagnostic classifications were key in this attempt at positivization. This paper aims to point out which subjectifying elements participated in the application of diagnoses such as schizophrenia, psychopathy, and oligophrenia in the women's wards of the Manicomio Provincial de Málaga, and to show how the hegemonic ideal of femininity established a permeable limit between sanity and madness of women, between assimilations and resistances.

Las historias clínicas de manicomios de mujeres permiten ahondar en la brecha que se abre entre la ilusión positivista de la psiquiatría durante la primera mitad del siglo XX en España y la vivencia subjetiva del internamiento psiquiátrico de las mujeres-locas doblemente subalternas. Las clasificaciones diagnósticas fueron claves en este intento de positivización. El objetivo de este trabajo es señalar qué elementos subjetivantes participaron en la aplicación de diagnósticos como esquizofrenia, psicopatía y oligofrenia en la sala de mujeres del Manicomio Provincial de Málaga, y mostrar cómo el ideal hegemónico de feminidad estableció un límite permeable entre la cordura y la locura de las mujeres, entre asimilaciones y resistencias.

Aprendendo com histórias: narrativas de experiências de uma cidade com a loucura / Learning from stories: narratives of experiences in a city with madness / Aprendiendo con historias: narrativas de experiencias de una ciudad con la locura

A cidade de Cariacica-ES foi sede do primeiro hospital psiquiátrico público do estado-local que produziu marcas na memória de uma cidade, que se acostumou a manter a loucura à distância, trancafiada nos muros do manicômio. Com as lutas provenientes da Reforma Psiquiátrica, os manicômios tiveram seus muros abalados e a proposta de um cuidado territorial começou a ser posta em prática: a loucura passou a habitar outros espaços da cidade. O presente artigo foi construído a partir de uma experiência investigativa que utilizou como método a História Oral, no intuito de conhecer, a partir de relatos de experiências de moradores e profissionais da saúde mental, os modos como a loucura foi acolhida em Cariacica-ES para além do espaço manicomial, a partir dos Serviços Residenciais Terapêuticos, após a abertura dos muros físicos do antigo Hospital Adauto Botelho.

The city of Cariacica-ES was the headquarters of the first public psychiatric hospital in the state, a place that produced marks in the memory of a city used to seeing madness far away, excluded and locked in the walls of the mental institution. With the struggles arising from the Psychiatric Reform, the asylums had their walls knocked down, and the proposal for territorial care began to be put into practice: madness began to inhabit other spaces in the city. This article was made from an investigative experience which used Oral History as a method to know, from the experiences of residents and mental health professionals, how madness was welcomed in Cariacica city beyond a mental asylum space, and from the Therapeutic Residential Services, after the opening of the physical walls of the former Adauto Botelho Hospital. (AU)

La ciudad de Cariacica, situada en el estado de Espírito Santo, fue sede del primer hospital psiquiátrico público, un lugar que dejó huellas en la memoria de una ciudad acostumbrada a ver la locura desde la distancia, encerrada en los muros del hospital. En virtud de las luchas surgidas de la Reforma Psiquiátrica, los manicomios tuvieron sus muros derribados y se empezó a poner en práctica la propuesta del cuidado territorial, la locura comenzó a habitar otros espacios de la ciudad, componiéndolos. Este artículo se construyó a partir de una experiencia investigativa que utilizó la Historia Oral como método, con el fin de conocer, a partir de relatos de experiencias de residentes locales y profesionales de la salud mental, cómo la locura fue acogida por la ciudad, más allá del espacio hospitalario, a partir de los Servicios Residenciales Terapéuticos, tras la apertura de los muros físicos del antiguo Hospital Adauto Botelho. (AU)

Assistance to black people in the Juquery asylum from 1898 to 1930 / A assistência ao negro na instituição asilar do Juquery de 1898 a 1930

ABSTRACT OBJECTIVE To reveal the assistance provided to black individuals hospitalized at the Juquery Asylum from 1898 to 1930, having considered the social context and the hegemony of medical knowledge of the time. METHODS Exploratory-descriptive, qualitative study, documentary analysis, in medical records of black individuals hospitalized at the Juquery Asylum from 1898 to 1930. The time frame encompassed specific institutional directions as well as the historical, political, economic, and social context experienced by the black population. Held at the archive of the historical and cultural heritage of the Juquery Hospital Complex, between July and December 2019. We used an instrument with questions related to sociodemographic data, date and anamnesis of entry, physical and psychological examination, diagnostic hypothesis, treatments performed, complications, outcome, and motive. The analysis was carried out according to stages of documentary analysis and was based on psychiatric theoretical references of the period. RESULT All medical records of the period were read (approximately 6,300), of which about 1,400 were of black individuals. Of these medical records, 457 were included, 140 of women and 317 of men, which were considered to have significant information for the study's objectives. Most of the participants had long-term hospitalizations, whose motive did not seem to be linked to the possibility of cure or social reintegration, but rather to segregation. From the diagnoses described, the impression is that these subjects composed a niche with immutable, permanent conditions, not amenable to therapeutics that would allow their return to society, exemplified by degeneration. A significant amount of the medical records do not contain data on treatments, which reinforces the hypothesis that they were kept hospitalized not for the purpose of care, but as a deposit of incurability; when they do bring data, we observe willful empiricism of the physician. Half of the medical records describe the outcomes of hospitalized people and indicate very high records of deaths, followed by referrals to other hospitalization institutions to prolong confinement. CONCLUSIONS Internees suffered from isolation and assistance focused on state policy allied to science, especially psychiatry, to legitimize exclusion of the socially undesirable.

RESUMO OBJETIVO Desvelar a assistência prestada aos indivíduos negros internados no período de 1898 a 1930 no Hospício do Juquery, considerados o contexto social e a hegemonia do saber médico da época. MÉTODOS Estudo exploratório-descritivo, qualitativo, análise documental, em prontuários de indivíduos negros(as) internados(as) desde a abertura do Hospício do Juquery em 1898 até 1930. Recorte temporal abarcou direções institucionais específicas e contexto histórico, político, econômico e social vivenciado pela população negra. Realizado no Arquivo do Patrimônio Histórico-cultural do Complexo Hospitalar do Juquery, entre julho e dezembro de 2019. Utilizado instrumento com questões referentes a dados sociodemográficos, data e anamnese de entrada, exame físico e psíquico, hipótese diagnóstica, tratamentos realizados, intercorrências, desfecho e motivo. Análise realizada segundo etapas da análise documental e pautada nos referenciais teóricos psiquiátricos do período. RESULTADOS Foram vistos todos os prontuários do período, cerca de 6.300, dos quais aproximadamente 1.400 eram de negros(as). Desses prontuários, foram incluídos 457, 140 de mulheres e 317 de homens, considerados com informações significativas para objetivos do estudo. Maioria dos participantes teve internações de longa permanência, cuja finalidade não pareceu estar atrelada à possibilidade de cura ou reinserção social, mas à segregação. A partir dos diagnósticos descritos, a impressão é que esses sujeitos compunham nicho com condições imutáveis, permanentes, não passíveis de terapêuticas que possibilitassem retorno à sociedade, exemplificada pela degeneração. Quantidade significativa dos prontuários não traz dados sobre tratamentos, o que reforça a hipótese de que eram mantidos internados não para proposta de cuidado, mas como um depósito da incurabilidade; quando trazem dados observamos empirismo voluntarioso do médico. Metade dos prontuários descreve os desfechos das pessoas internadas e apontam registros muito altos de mortes, seguidos de encaminhamentos para outras instituições de internação a prolongar a vida de confinamento. CONCLUSÕES Internados sofreram com isolamento e assistência focados na política de Estado aliada à ciência, sobretudo psiquiátrica, para legitimar exclusão dos socialmente indesejáveis.

One hundred thirty years of Dom Pedro II's death: "the emperor of the tropics" and the beginning of Brazilian Psychiatry / Cento e trinta anos da morte de Dom Pedro II: "o imperador dos trópicos" e o começo da psiquiatria brasileira

OBJETIVO: Associar a trajetória de vida de Dom Pedro II com o começo da história da psiquiatria brasileira por meio do Hospício Pedro II. MÉTODOS: Realizamos uma revisão narrativa da literatura com a pesquisa de três bases de dados: Google Scholar, PubMed e Web of Science (SciELO). RESULTADOS: A primeira instituição psiquiátrica brasileira, o Hospício Pedro II (1841-1889), foi criado por meio do Decreto nº 82, publicado no dia 18 de julho de 1841. Essa publicação ocorreu durante a cerimônia de coroação de Dom Pedro II. O objetivo dessa cerimônia de coroação era fortalecer o poder da monarquia brasileira e legitimizar a antecipação da maioridade do imperador com 14 anos. Ao longo dos 48 anos do império de Dom Pedro II, seus interesses culturais e científicos influenciaram o surgimento de uma incipiente pesquisa científica brasileira. Nesse sentido, o Hospício Pedro II não era apenas representativo de uma instituição de saúde, mas uma resposta às mudanças sociais e culturais que ocorreram após a chegada da família real portuguesa em 1808. Também era um representativo da influência da psiquiatria francesa baseada no tratamento moral de Phillipe Pinel (1745-1826). CONCLUSÃO: De forma concisa, o Hospício Pedro II era uma representação da personalidade de Dom Pedro II como um patrono da ciência, a emergência de uma psiquiatria brasileira e da hierarquia da sociedade imperial.

OBJECTIVE: Associate Dom Pedro II's life trajectory and the beginning of Brazilian psychiatry through the Pedro II Asylum. METHODS: We conducted a narrative review of the literature on three search databases: Google Scholar, PubMed, and Web of Science (SciELO). RESULTS: The first Brazilian psychiatry institution, the Pedro II Asylum (1841-1889), was created by the number 82 decree on 18 July 1841. The launching occurred at Dom Pedro II's coronation ceremony. It was a celebration that aimed at enhancing the Brazilian monarch's power and at legitimizing the emperor's adulthood at the age of fourteen. Throughout the 48 years of the Dom Pedro II empire, his cultural and science interests influenced the emergence of incipient Brazilian scientific research. In this regard, the Pedro II Asylum was portrayed not only as a health care institution but also undertook an effort to attend the social and cultural modifications promoted at the Brazilian imperial court after the Portuguese Crown family arrived in 1808. It also represented the influence of French psychiatry based on Phillipe Pinel's (1745- 1826) principles of moral treatment. CONCLUSIONS: Concisely, the Pedro II Asylum was a representation of Dom Pedro II's personality as a patron of science, the emergence of Brazilian psychiatry, and the imperial society hierarchy.

Reseña histórica del Hospital Psiquiátrico Crisanto Betancourt Hernández de Mayabeque / Historical review of Crisanto Betancourt Hernández Psychiatric Hospital of Mayabeque

La atención al enfermo mental ha estado centrada en el hospital psiquiátrico, eje fundamental del tratamiento a enfermedades mentales. Con la reorientación de la psiquiatría, los hospitales psiquiátricos desarrollan una labor comunitaria coordinada entre el nivel deatención primario y el secundario. El Hospital Psiquiátrico Crisanto Betancourt Hernández¨, representa a este tipo de entidad, lo que motiva a explorar su evolución histórica. Las referencias se obtienen de las entrevistas a los fundadores, los vecinos, la exploración de documentos, las fotos, los reconocimientos y las condecoraciones. Se constata que ha crecido en la calidad de los servicios, la transformación de nuevas instalaciones; la reducción de camas acorde al desarrollo de la reorientación de la especialidad, la proyección comunitaria en el primer nivel de atención; la formación del personal idóneo para la realización de esta labor y su superación científica.(AU)

Care to the mental ill patients has been centered at psychiatric hospitals, important axis of the treatment for mental diseases. With the reorientation of Psychiatry, the psychiatric hospitals develop a community work coordinated between Primary and Secondary Health Cares ¨Crisanto Betancourt Hernández Psychiatric Hospital, represents this type of entity, soit motivated to explore its historical evolution. References were obtained by interviews tofounders, neighbors, exploration of documents, pictures, acknowledgements and awards. It is confirmed that the hospital has improved in the quality of services, transformation of new installations; reduction of beds according to the development of the reorientation of thespecialty, the communitarian projection in the first level of Care; the formation of the competent personnel for the performance of this task and their scientific training.(AU)

Owning our madness: Contributions of Jamaican psychiatry to decolonizing Global Mental Health.

The contentious debate on evidence-based Global Mental Health care is challenged by the primary mental health program of Jamaica. Political independence in 1962 ushered in the postcolonial Jamaican Government and the deinstitutionalization of the country's only mental hospital along with a plethora of mental health public policy innovations. The training locally of mental health professionals catalyzed institutional change. The mental health challenge for descendants of African people enslaved in Jamaica is to reverse the psychological impact of 500 years of European racism and colonial oppression and create a blueprint for the decolonization of GMH. The core innovations were the gradual downsizing and dismantling of the colonial mental hospital and the establishment of a novel community mental health initiative. The successful management of acute psychosis in open medical wards of general hospitals and a Diversion at the Point of Arrest Programme (DAPA) resulted in the reduction of stigma and the assimilation of mental health care into medicine in Jamaica. Successful decentralization has led to unmasking underlying social psychopathology and the subsequent development of primary prevention therapeutic programs based on psychohistoriographic cultural therapy and the Dream-A-World Cultural Therapy interventions. The Jamaican experience suggests that diversity in GMH must be approached not simply as a demographic fact but with postcolonial strategies that counter the historical legacy of structural violence.

Historias locas: Internaciones psiquiátricas durante el siglo XX

Compilación del trabajo de investigación desarrollado sobre un fondo documental de historias clínicas del período 1895-1987 del Archivo Intermedio del Archivo General de la Nación, provenientes del Hospital Neuropsiquiátrico de Mujeres José Esteves, de la Provincia de Buenos Aires (Argentina). La investigación tuvo el aval de la Universidad Nacional de Lanús (UNL) y el CONICET, y se centró en la trayectoria del hospital en ese período, y la atención a la salud/enfermedad mental, partiendo de una presentación socio-epidemiológica de las personas internadas, y situándolas en su contexto socio-histórico y cultural.

Campo organizacional y cambio institucional en el Hospital Psiquiátrico del Valle entre 1956 y 1970 / Organizational and Institutional change in the Psychiatric Hospital of the Valle 1956-1970

La construcción de un Hospital Psiquiátrico moderno en el Departamento del Valle entre 1956 y 1961 supuso importantes transformaciones en el campo organizacional y en el sistema de creencias sobre la salud mental en la región del sur occidente colombiano. A nivel organizacional, la Junta Directiva del Asilo logró aglutinar esfuerzos de instituciones privadas y públicas en pro del mejoramiento de la atención de los enfermos mentales. Así mismo, con el apoyo del Departamento de Psiquiatría de la Universidad del Valle, cambió la praxis médica sobre la enfermedad mental e hizo del nuevo hospital, un espacio para la formación de especialistas en psiquiatría. En lo que respecta al sistema de creencias, las nuevas políticas implementadas por la OMS sobre la salud mental y el descubrimiento de nuevos tratamientos, operó cambios profundos en los modos de entender la enfermedad. Siguiendo una línea de investigación historiográfica que utilizó como fuente el archivo administrativo del Hospital, el presente trabajo describe el proceso de cambio institucional que se llevó a cabo en el Asilo, en su proceso de transición de Asilo a Hospital Psiquiátrico en Cali entre 1956 y 1960.

The construction of a modern Psychiatric Hospital in the Department of Valle led to significant transformations in the organizational field and the belief system about mental health in the region. At the organizational level, the Board of Directors of the Asylum managed to unite efforts of private and public institutions to improve the care of the mentally ill. Likewise, with the support of the Department of Psychiatry of the University of Valle, the medical practice on mental illness changed, and the new Hospital turned into a space for the training of specialists in psychiatry. Regarding the belief system, new policies implemented by WHO on the mental health and the discovery of new treatments for dementia brought about profound changes in the ways of understanding the disease. Following a line of historiographical research that used the Hospital's administrative file as a source, this work describes the process of institutional change that took place in the Asylum in its transition process from Asylum to Psychiatric Hospital in Cali between 1956 and 1960

[From the Hospício de Pedro II to the Hospital Nacional de Alienados: a hundred years of records (1841-1944)]. / Del Hospício de Pedro II al Hospital Nacional de Alienados: cien años de historias (1841-1944).

This research note lays out methodological approaches, documentary sources, historiographical inscription and reflections that arose from an ongoing research study entitled "From the Hospício de Pedro II to the Hospital Nacional de Alienados: a hundred years of records (1841-1944)." A group of researchers and students involved in the project have analyzed the history of the first psychiatric institution in Brazil for the period from the second half of the nineteenth century through the mid-twentieth century. They are also committed to the ideal of contributing to the organization and conservation of the documentary sources of this institution. Here we present the innovative nature of the project, especially due to its methodological approaches in combination with its focus on preserving historical documents.

Esta nota de investigación expone perspectivas metodológicas, fuentes documentales, inscripción historiográfica y reflexiones que surgen de la investigación en curso, titulada "Del Hospício de Pedro II al Hospital Nacional de Alienados: cien años de historias (1841-1944)". Un grupo de investigadores y estudiantes asociados al proyecto han analizado la historia de la primera institución psiquiátrica de Brasil en el periodo comprendido entre la segunda mitad del siglo XIX y mediados del siglo XX. También están comprometidos con el ideal de contribuir a la organización y conservación de los fondos documentales de esta institución. Aquí presentamos el carácter innovador del proyecto, especialmente por sus perspectivas metodológicas en combinación con enfoques de preservación de documentos históricos.

[Know-what and know-how in the Hospital-Asilo of Oliva (1914-1950): the Adela case]. / El saber ver y el saber hacer en el hospital-asilo de Oliva (1914-1950): el caso Adela.

This paper analyze multiple experiences about the functioning of the first Open-Door in Argentina's inside, the "Asilo Colonia Regional Mixto de Alienados Oliva", created in the province of Cordoba in 1914. We approach a set of clinical histories and specialized publications of the institutional bulletin, deepening in theoretical and therapeutic processes articulated during the first decade of hospitalization of a patient who lived in Oliva most of her adult life. This study case questions the relevance given to this madhouse as a space of reclusion and social control. We show that, in a context of crisis about institutional resources and transformation into psychiatric models, the configuration of know-what and know-how of these alienists did not constitute a monolithic authority, accounting for how the behaviors of patients and their relatives, values and social uses defined types of income, diagnoses and treatment possibilities.

En este trabajo analizamos múltiples experiencias en el funcionamiento del primer open-door creado en la provincia de Córdoba, en 1914: el "Asilo Colonia Regional Mixto de Alienados Oliva". Abordamos un conjunto de historias clínicas y publicaciones especializadas del boletín institucional, profundizando en procesos teóricos y terapéuticos articulados durante la primera década de internación de una paciente que vivió en Oliva la mayor parte de su vida adulta. Este estudio de caso, cuestiona la tradicional relevancia otorgada a este manicomio como espacio de reclusión y control social. Mostramos que, en un contexto de constante crisis de los recursos institucionales y de trasformación de los modelos psiquiátricos, la configuración del "saber ver" y el "saber hacer" de estos alienistas no constituyeron una autoridad monolítica, dando cuenta de cómo los comportamientos de los pacientes y sus allegados, los valores y usos sociales definían tipos de ingresos, diagnósticos y posibilidades de tratamiento.

Del Hospício de Pedro II al Hospital Nacional de Alienados: cien años de historias (1841-1944) / From the Hospício de Pedro II to the Hospital Nacional de Alienados: a hundred years of records (1841-1944)

Resumen Esta nota de investigación expone perspectivas metodológicas, fuentes documentales, inscripción historiográfica y reflexiones que surgen de la investigación en curso, titulada "Del Hospício de Pedro II al Hospital Nacional de Alienados: cien años de historias (1841-1944)". Un grupo de investigadores y estudiantes asociados al proyecto han analizado la historia de la primera institución psiquiátrica de Brasil en el periodo comprendido entre la segunda mitad del siglo XIX y mediados del siglo XX. También están comprometidos con el ideal de contribuir a la organización y conservación de los fondos documentales de esta institución. Aquí presentamos el carácter innovador del proyecto, especialmente por sus perspectivas metodológicas en combinación con enfoques de preservación de documentos históricos.

Abstract This research note lays out methodological approaches, documentary sources, historiographical inscription and reflections that arose from an ongoing research study entitled "From the Hospício de Pedro II to the Hospital Nacional de Alienados: a hundred years of records (1841-1944)." A group of researchers and students involved in the project have analyzed the history of the first psychiatric institution in Brazil for the period from the second half of the nineteenth century through the mid-twentieth century. They are also committed to the ideal of contributing to the organization and conservation of the documentary sources of this institution. Here we present the innovative nature of the project, especially due to its methodological approaches in combination with its focus on preserving historical documents.

Casas de Locos: The Treatment of the Mentally Ill in the Hispanic World Before the Enlightenment.

Before the Enlightenment, the mentally ill in the Hispanic world received standard medical care. After the foundation of the first hospital for specific treatment for mentally ill in Valencia in 1409, a number of hospitals opened their doors to patients with mental illness across the Iberian Peninsula during the 15th century. This model of medical care for people with mental illness was carried to America and the Philippines soon after the arrival of the Spaniards. The treatment for the mentally ill in the Hispanic World influenced the development of Pinel's moral treatment and the care of the mentally ill during the Enlightenment. This article will explain the circumstances leading to the foundation of a number of specific hospitals for the mentally ill in the Hispanic territories as well as the kind of care that these patients received at the so-called casas de locos.

[In the middle of the road there was a stone: the history of violence and social suffering among young adults with trajectories of psychiatric hospitalization]. / No meio do caminho tinha uma pedra: a história de violência e sofrimento social de jovens adultos com trajetórias de internação em hospital psiquiátrico.

This article presents the life stories of three young adults with a long history of psychiatric hospitalization who became residents of a psychiatric hospital in Sorocaba (SP), in a region known as a center for the mentally ill. This study analyzes mental health policies and their effects on the lives of these individuals based on discussions about social suffering. Using the participant objectivation technique, these individuals were followed for two years after dehospitalization. The results show that health policy in Sorocaba has been advanced through totalizing and coercive schemes with institutionalization and medicalization comprising the "solution" to some social problems.

São apresentadas as histórias de vida de três jovens adultos, com longo período de internação psiquiátrica, que se tornaram moradores de hospital psiquiátrico em Sorocaba (SP), em uma região caracterizada como polo manicomial. Objetivou-se analisar as políticas de saúde mental e os efeitos de suas ações na vida daqueles sujeitos, tendo como premissas as discussões sobre sofrimento social. Por meio da "objetivação participante", acompanharam-se, durante dois anos, suas trajetórias após o processo de desospitalização. Como resultado, aponta-se que a política de saúde naquele município tem sido promovida por meio de esquemas totalizantes e coercitivos, em que a institucionalização da vida, com a sua medicalização, constitui a "resposta" para alguns problemas sociais.

No meio do caminho tinha uma pedra: a história de violência e sofrimento social de jovens adultos com trajetórias de internação em hospital psiquiátrico / In the middle of the road there was a stone: the history of violence and social suffering among young adults with trajectories of psychiatric hospitalization

Resumo São apresentadas as histórias de vida de três jovens adultos, com longo período de internação psiquiátrica, que se tornaram moradores de hospital psiquiátrico em Sorocaba (SP), em uma região caracterizada como polo manicomial. Objetivou-se analisar as políticas de saúde mental e os efeitos de suas ações na vida daqueles sujeitos, tendo como premissas as discussões sobre sofrimento social. Por meio da "objetivação participante", acompanharam-se, durante dois anos, suas trajetórias após o processo de desospitalização. Como resultado, aponta-se que a política de saúde naquele município tem sido promovida por meio de esquemas totalizantes e coercitivos, em que a institucionalização da vida, com a sua medicalização, constitui a "resposta" para alguns problemas sociais.

Abstract This article presents the life stories of three young adults with a long history of psychiatric hospitalization who became residents of a psychiatric hospital in Sorocaba (SP), in a region known as a center for the mentally ill. This study analyzes mental health policies and their effects on the lives of these individuals based on discussions about social suffering. Using the participant objectivation technique, these individuals were followed for two years after dehospitalization. The results show that health policy in Sorocaba has been advanced through totalizing and coercive schemes with institutionalization and medicalization comprising the "solution" to some social problems.

El saber ver y el saber hacer en el hospital-asilo de Oliva (1914-1950): el caso Adela / Know-what and know-how in the Hospital-Asilo of Oliva (1914-1950): the Adela case

RESUMEN En este trabajo analizamos múltiples experiencias en el funcionamiento del primer open-door creado en la provincia de Córdoba, en 1914: el "Asilo Colonia Regional Mixto de Alienados Oliva". Abordamos un conjunto de historias clínicas y publicaciones especializadas del boletín institucional, profundizando en procesos teóricos y terapéuticos articulados durante la primera década de internación de una paciente que vivió en Oliva la mayor parte de su vida adulta. Este estudio de caso, cuestiona la tradicional relevancia otorgada a este manicomio como espacio de reclusión y control social. Mostramos que, en un contexto de constante crisis de los recursos institucionales y de trasformación de los modelos psiquiátricos, la configuración del "saber ver" y el "saber hacer" de estos alienistas no constituyeron una autoridad monolítica, dando cuenta de cómo los comportamientos de los pacientes y sus allegados, los valores y usos sociales definían tipos de ingresos, diagnósticos y posibilidades de tratamiento.

ABSTRACT This paper analyze multiple experiences about the functioning of the first Open-Door in Argentina's inside, the "Asilo Colonia Regional Mixto de Alienados Oliva", created in the province of Cordoba in 1914. We approach a set of clinical histories and specialized publications of the institutional bulletin, deepening in theoretical and therapeutic processes articulated during the first decade of hospitalization of a patient who lived in Oliva most of her adult life. This study case questions the relevance given to this madhouse as a space of reclusion and social control. We show that, in a context of crisis about institutional resources and transformation into psychiatric models, the configuration of know-what and know-how of these alienists did not constitute a monolithic authority, accounting for how the behaviors of patients and their relatives, values and social uses defined types of income, diagnoses and treatment possibilities.

Monitoring the correspondence of the mentally ill in Spanish psychiatric institutions: from care to censorship, 1852-1987. / El control de la correspondencia de los enfermos mentales en las instituciones psiquiátricas españolas: entre el cuidado y la censura, 1852-1987.

This article examines the legislation allowing confiscation of the correspondence of the mentally ill in psychiatric hospitals. Arguing a duty of care, patients' letters were read by physicians and administrators. A study was performed of the regulations governing this practice in different Spanish institutions from the nineteenth century on; the measure was implemented by staff members under orders from their superiors. This arbitrary decision meant that a great deal of correspondence remains in the archives of psychiatric establishments in different locations; nowadays, these letters can be used as valuable clinical documents that help us to understand daily life in those institutions and, obviously, mental health patients' subjective experience of their confinement.

Este trabajo pretende aproximarse a la legislación que ha permitido retener la correspondencia de los enfermos mentales en los hospitales psiquiátricos. Amparándose en el cuidado, las cartas eran leídas por médicos y administradores. Se ha realizado una búsqueda de los reglamentos que avalaban esta práctica en diferentes instituciones españolas desde el siglo XIX, medida ejercida por el personal subalterno por orden de sus superiores. Esta arbitraria decisión ha provocado que numerosa correspondencia permanezca en archivos de establecimientos psiquiátricos de diferentes latitudes, de modo que, actualmente, se pueden utilizar como valiosos documentos clínicos para conocer la vida cotidiana de dichas instituciones y, sin duda, la experiencia subjetiva de los enfermos mentales ante el internamiento.