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：分析某精神病院关停所引发的去机构化进程，并了解服务使用者出院后的去向与结局。
方法：本研究为基于批判分析视角的描述性质性研究，研究场所为里约博尼图殖民地医院（Hospital Colônia de Rio Bonito）。本研究对参与该去机构化进程的5名管理人员的机构档案与口述叙事进行了分析。
结果：里约博尼图殖民地医院的去机构化进程时长超出预期。为顺利推进该进程，需实施三方干预，尤其有赖于各城市开展网络动员并落地精神社会关怀网络（Psychosocial Care Networks）。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。
结语：里约博尼图殖民地医院的去机构化进程推动了服务与服务对象间的联结构建，亦是推动市级层面精神社会关怀网络落地的有力载体。