Open and closed services in the treatment of alcohol and other drugs from the user point of view

Resumen

Deinstitutionalization is meant to rescue the citizenship of people in psychological distress and use of drugs, by using an expanded network of services that provide integral care. This article is aimed at discussing how the treatment modalities offered by mental health services in the formal health network contribute to or prevent the deinstitutionalization process by analyzing integral care. To accomplish this task we used the techniques life history and participant observation. We analyzed the data based on critical and reflective hermeneutic perspectives of the subjects’ narratives and daily practices. The results showed that the functioning of closed services is more in tune with the legal-moral and medical models of drug use analysis and more distant from the principles of integrality, fulfilling roles related to social inequalities and the absence of public policies. The Psychosocial Care Center (CAPS) is closer to the psychosocial and socio-cultural models, moving towards an integral health practice. Such results point to the need of future research to deepen the role of these services in the Psychosocial Care Network (RAPS), the increasing dissemination and financing of closed services in Brazil and their effects on the deinstitutionalization of drug users.