Evaluation and promotion of human rights culture in Centros de Atenção Psicossocial: QualityRights potentialities and challenges

Abstract

The violation of human rights of people with mental health problems is still a worldwide reality. Studies indicate that violations occur in different life scenarios, either in different places in everyday life and family contexts or psychiatric hospitals and community-based mental health services. In 2012, the World Health Organization Department of Mental Health and Substance Abuse launched the QualityRights Initiative and, in developing service evaluation proposals, developed, based on the Convention on the Rights of Persons with Disabilities, the QualityRights tool kit (QR). At the national level, the theme of rights of people with mental health problems is central to the process of psychiatric reform developed under the Unified Health System. However, the literature review indicates that studies, assessments, and analyzes that refer to or adopt the QR in the national scenario are still recent and restricted. General objective: To identify and analyze the potentialities and challenges of the QR from the perspective of evaluating services and promoting and strengthening the culture of human rights in the practices of the Centros de Atenção Psicossocial (CAPS). Specific Objectives: (I) to evaluate the quality of CAPS III and CAPSad III from the perspective of promoting and strengthening human rights through the QR; (II) to analyze the perception of people with mental health problems and of professionals from CAPS III and CAPSad III concerning the themes of Human Rights (HR), citizenship, violation of rights and experience of the QR; (III) analyze the potentialities and challenges of the development of QR in CAPS III and CAPSad III, aiming at improving CAPS practices aimed at promoting human rights and strengthening the contractual power of people with mental health problems; (IV) to develop a training process on mental health and HR for the research participants; (V) to contribute to the debate and the formulation of proposals for the promotion of human rights in CAPS in the perspective of the improvement of substitutive and territorial services in the context of the Unified Health System. Methodology: This is an exploratory, descriptive study with a qualitative and quantitative approach, and for its development, different data collection and analysis procedures will be adopted. The study will be developed in the scenarios of the Centro de Atenção Psicossocial III Adult Itaim Bibi and the Centro de Atenção Psicossocial III Alcohol and Drugs in Brasilândia in two stages. In the first, the services' evaluation is foreseen, based on 3 of the 5 themes indicated by the QR. According to the QR toolkit's main orientations, it will be carried out: analysis of documentation, observation, and interviews with users and professionals of the services. The data will be analyzed according to the guidelines of the QR. In stage 2 / Phase A, focus groups' development is foreseen, with users and service professionals. Two meetings per group will be recorded, and thematic analysis will be carried out. In Phase B of this stage, it is intended to develop two training processes, one for users and the other for professionals, of the two services, totaling 40 hours. Expected Results: to strengthen care practices of freedom from the perspective of HR, in the view of people with mental health problems and professionals of Centros de Atenção Psicossocial (CAPS); contribute to the formulation of propositions in the promotion of HR in CAPS in the perspective of improving substitutive and territorial services in the context of the Unified Health System; contribute to the development of Public Mental Health Policies based on the perspective of QR and to contribute to the development of a culture of assessment of mental health services. (AU)