Tactical productions of users and workers of mental health programs: an ethnographic study in a school health center in the west zone of São Paulo

Abstract

The article presents an outline of research on access to mental health services in São Paulo, focusing on the tactics of users and workers of a mental health program in a school healthcare center, constellating possibilities and confronting limits of the established policies. This was an ethnographic study conducted at the reception of the referred program, revealing the dimensions of everyday productions that qualify the participation of users and workers in the construction of public policy, on the perspective discussed Michel de Certeau. The article explains, first, some theoretical and methodological links that support the study, combining the concept of tactics, differences and tensions between instituted policy and its appropriation by the population and ethnography. It then presents the Mental Health Program in which the survey was conducted, seeking to show its unique and "survivor" character, in view of the current policy guidelines on mental health and primary care. The interpretation of the observed material was based on the notions of discipline and imagination, examining primarily the bonds, the malaise, the medication, the reception, care and humor.