Os esquecidos : familismo e assistência pública na inimputabilidade por doença e deficiência mental no Brasil

Abstract

This thesis is a study of both quantitative and qualitative methods of data collection and analysis on the suspension of internment process of individuals in security measures that have already met the psychiatric and criminal criteria for returning to freedom. Security measure is a device created in the 1940 Brazilian Penal Code to ensure compulsory psychiatric treatment to individuals with mental illness or disability who have been diagnosed, at the time of the crime, as unable to understand the wrongfulness of the act or determined in accordance with this disability. Security measures can be outpatient treatment and/or hospitalization; the latter being performed on restriction of freedom, both being accompanied and executed by the Custody and Psychiatric Treatment Institutions (ECTPs). According to the 2012 publication The custody and psychiatric treatment in Brazil -Census 2011, there were 2,956 individuals under security measures in the country in 2011 within the 26 existing ECTPs. At least 25% of those (741) should not be admitted because they are already danger-free, or have a suspension of internment sentence, extinct security measure or detention without judicial process. These 25% of individuals in security measures that have already met the criteria for suspension but are still in undue freedom restriction, are called in this thesis the forgotten of Brazilian forensic psychiatric hospitals. An analysis of mental health policies and social assistance was done to assess how they interrelate with the public security policy at the time of suspension of internment of individuals in safety measures. The hypothesis that guided the empirical analysis in this thesis was that both welfare and mental health policies are structured according to welfare provision of shared responsibility of individuals between the State and families. As individuals in security measures, especially at the stage of suspension of internment, have complex relationships with their families and many of them have no relationships with family members whatsoever, sharing responsibility policies might prevent their social protection in the suspension of internment phase, causing undue freedom restriction. We investigated whether there was presence of familism in mental health and assistance policies. Familism is a feature of social policies in which the family is seen as an agent that offers goods and services for the well-being of individuals, assuming most of the functions of public policies that should be of State responsibility. It was outlined that, in the case of mental health policies and social welfare in Brazil, familism manifests itself in three different ways: sharing familism, transfer familism and default familism. In the case of security measures in suspension of internment, these three types of familism are present and are able to explain the emergence of the forgotten of Brazilian forensic psychiatric hospitals.

Cuidado na dependência complexa de pessoas com deficiência: uma questão de justiça

“…Nele, a família é designada como principal responsável pelo bem-estar dos seus membros e as mulheres recebem uma carga desproporcional de atividades de cuidado (Luana PASSOS; Celia KERTENETSKI; Danielle CARUSI MACHADO, 2021). Wederson Santos (2017;2014) e Gøsta Esping-Andersen (1990) apontam que, nesse sistema, a presença do Estado como agente responsável pelo cuidado da população é bastante reduzida, visto as famílias serem as principais promotoras de cuidados e proteção social, assumindo funções que deveriam ser prestadas pelo Estado por meio de políticas públicas.…”