Abstract
A direct result of the Psychiatric Reform in Brazil, Psychosocial Care Centers (CAPS) are community-based health services for individuals diagnosed with severe and/or persistent mental disorders. Based on Erving Goffman’s approach, this study aims to analyze the practical effects of the CAPS mode of operation, more specifically the elimination of the compulsory nature of treatment and the affirmation of voluntary participation in the dynamics of users’ primary and secondary adjustments to the institution. Our analysis concerned data collected in a research conducted at a CAPS in the municipality of São Paulo from 2014 to 2016. The analysis indicates that the voluntary nature of participation at the CAPS neither necessarily translates into adherence to the institution nor eliminates the problematic character of users’ cooperation with the proposed routine. Adjustment to the concept of self, linked to mental symptoms, remains a conflictive process.
Keywords:
Primary adjustments; Secondary adjustments; Psychosocial Care Center; Erving Goffman; Madness