THERAPEUTIC COMMUNITIES: Treatment Proposal for Substance Dependence and the Principles of Psychiatric Reform and the National Mental Health Policy Cláudia Moraes da Silva, Amélia Cohn

Abstract

This article aims to reflect on the use of Therapeutic Communities (TCs), regulated by the National Agency of Sanitary Surveillance (ANVISA) and included by the Ministry of Health in the Network of Psychosocial Care, as a proposal for the treatment of substance dependence psychoactive, in face of the principles of the Psychiatric Reform and the current National Mental Health Policy, which prioritizes outpatient treatment. A brief analysis of the model of treatment of the therapeutic communities and their objectives will be made, in order to verify the compatibility of the use of these institutions as a social device in the care of people with mental suffering or disorder and needs arising from the use of psychoactive substances, with the principles of the Psychiatric Reform and the objectives of the current National Mental Health Policy. The research was based on bibliography, academic texts, official and normative documents on the protection of people affected by mental disorders and on the improvement of mental health care. The result showed that, contrary to the National Mental Health Policy and the principles of Psychiatric Reform that prioritize outpatient treatment and aim to reduce / extinguish psychiatric hospitals, there is a public policy to encourage the creation of beds in Therapeutic Communities, a contributory fator for the significant increase of these institutions in recent years. It was also realized that psychiatric reform did not alter the secular culture of imposing deprivation of liberty on psychoactive substance dependents, albeit under the guise of treatment.