Deinstitutionalization and network of mental health services: a new scene in health care

ABSTRACT Objective: to analyze the process of deinstitutionalization resulting from a psychiatric hospital shut down, and know the fate of users after dehospitalization. Method: a descriptive, qualitative study based on the critical-analytical perspective, which had as its setting the Hospital Colônia de Rio Bonito. Institutional documents and narratives of five managers who participated in the deinstitutionalization process were analyzed. Results: Hospital Colônia deinstitutionalization lasted longer than expected. For this to happen, a tripartite intervention was necessary, and especially the mobilization of networks and implementation of Psychosocial Care Networks by the cities. Regarding destination of users, most were referred to therapeutic or transinstitutionalized residences. Final considerations: Hospital Colônia deinstitutionalization led to the establishment of connections between services and people. This was a powerful device for the implementation of Psychosocial Care Networks at municipal level.

摘要
目的：分析精神病院关停引发的去机构化（deinstitutionalization）进程，明晰服务使用者在出院后的去向。
方法：本研究为基于批判-分析视角的描述性质性研究，研究现场为里约博尼图殖民地医院（Hospital Colônia de Rio Bonito）；本研究对机构相关文件及5名参与去机构化进程的管理者的叙事资料进行了分析。
结果：里约博尼图殖民地医院的去机构化进程耗时超出预期。为推进该进程，需开展三方干预，尤其需要各城市推动网络动员与社会心理照护网络（Psychosocial Care Networks）的搭建。关于服务使用者的去向，多数被转介至治疗性居所或跨机构安置居所。
结论：里约博尼图殖民地医院的去机构化进程促成了服务与服务对象间的联结搭建，是推动市级层面社会心理照护网络落地的有效载体。