This Thursday (5), users of mental health services, their families, workers and popular movements in the anti-asylum struggle demonstrate at the door of the Regional Council of Medicine (CRM). The act takes place against a request from the CRM for interdiction in the sixteen Reference Centers in Mental Health (CERSAM) in Belo Horizonte.
A public note from the Regional Council of Medicine of Minas Gerais caused an uproar last week. Launched on July 24 and published in several newspapers, the council informed that it would carry out an “ethical ban” on medical activities in 16 Reference Centers in Mental Health (Cersams) in Belo Horizonte.
The reasons given by the Medical Council are the absence of a doctor, insufficient number of professionals and a night shift without the presence of a psychiatrist.
The possible interdiction of the Cersams caused a wave of commotion in the most diverse health entities in Belo Horizonte. A joint note from four medical groups highlighted that councils cannot carry out this type of closure. This function is the responsibility of the Health Surveillance, under the terms of law 9,782.
The collectives classify the council’s attitude as “irresponsible in view of the lack of assistance to the population that such an interdiction” can cause. Signing the note is the Psychiatry, Democracy and Care in Freedom Movement; the Brazilian Association of Female Doctors for Democracy of Minas; the Mineiro Nucleus of the Brazilian Association of Female Doctors for Democracy; and the National Network of Popular Doctors and Doctors.
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The Municipal Public Servants and Employees Union of BH (Sindibel) also spoke out against the attempt by the Medical Council. “The advances achieved by the Psychiatric Reform and the Anti-Asylum Fight in Belo Horizonte are a democratic achievement and have made Belo Horizonte a reference for care in freedom for all of Brazil”, said the union.
Cersams remain open
The Municipality of Belo Horizonte responded to the report that the Reference Centers in Mental Health will continue to function normally. “The municipality does not recognize any of the irregularities pointed out”, he informed.
He also clarified that, according to Ministry of Health guidelines, the financing of psychiatric beds is being reverted to the cost of outpatient equipment, with a comprehensive and humanized therapeutic proposal. This position goes against the criticism of the Regional Council of Medicine about the lack of psychiatrists on duty who, in fact, would not be a requirement for services at Cersams.
“The first thing that is important to clarify is that there are, yes, doctors in the professional staff of Cersams”, says Laura Fusaro Camey, vice-president of the Association of Users of Mental Health Service of MG. “Our service follows the existing ordinances. The Medical Council asks for a medical technical director, who is a position in the CFM ordinance [Conselho Federal de Medicina] of 1,932, 50 years before the emergence of the SUS”, he explains.
In Laura’s opinion, the denunciation of the Medical Council has as its background the position of this entity against anti-asylum treatment.
“The Regional Council of Medicine has never acted against any psychiatric hospital or therapeutic community. We have robust reports, 500 pages long, with things on the order of the abominable – institutional practices of violating correspondence, people physically restrained for days at a time, prescription of drugs with the intention of doping them for days at a time, torture rooms and there were doctors who would go there. But the CRM didn’t do anything”, laments Laura.
The conflict’s background would be related to the closing of Galba Veloso
This theory is strengthened by the fact that the closing of the Galba Veloso Hospital in Belo Horizonte, which had psychiatric inpatient beds, was one of the reasons cited by the Regional Council of Medicine to the media. In the council’s argument, the closing of the vacancies caused a flow of patients to the Cersams, therefore, these equipments should have psychiatrists to attend them.
However, unlike Galba Veloso, the CERSAMs are part of a free mental health treatment network. In the day shift, the Cersams carry out the reception of patients without limitation of vacancies. In the night modality, there are 92 vacancies, in addition to 10 beds at the Metropolitan Hospital Dr. Célio de Castro, where patients who need hospitalization are referred.
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Janaína Dornas, coordinator of the Municipal Psychiatric Reform Commission of the Municipal Health Council of Belo Horizonte, stresses that the closing of the psychiatric beds at Galba Veloso was agreed upon.
“Since Galba closed, people from the Municipal Psychiatric Reform Commission have been going every week to the Raul Soares Institute, which is a psychiatric hospital in Belo Horizonte that serves the entire state, and there has never been a lack of vacancies”, he guarantees. According to Janaína, since 2016 there has never been a 100% capacity at the extinct Galba Veloso. “And with the closure, there is still no shortage of vacancies at the Raul Soares Institute”, he completes.
Municipal Health Council expresses itself
To debate the possible interdiction of the Cersams, the Municipal Health Council held a plenary on July 29 with the participation of 400 people, which was classified by the council as “historic”. Those present decided to manifest themselves for the maintenance of the CERSAMs.
“Collectively, the indisputable defense of the SUS-BH Psychosocial Care Network (RAPS) was reaffirmed once again, comprising the CERSAMs and the Psychiatric Emergency Services (SUPs), in its model of care in freedom and anti-asylum”, stated a note from the Health Council.
However, it was also requested that the Municipal Health Department of Belo Horizonte present an action plan, within 30 days, to address the problems of CERSAMs, such as expansion and recomposition of professional teams, permanent education, inputs and material resources in adequate quantity and quality.
Belo Horizonte has 8 Mental Health Reference Centers (CERSAM) and 5 Mental Health Reference Centers – Alcohol and other Drugs (CERSAM-AD). These units offer 24-hour services, operating every day of the week, including Saturdays, Sundays and holidays. With regard to mental health care for children and adolescents, there are 3 specialized centers (CERSAMIs).
Also part of the Psychosocial Care Network: 33 Therapeutic Residences, 4 Street Clinics and 2 Adult and Child-Youth Transitional Care Units; in addition to 9 community centers and the entire primary care service complex, the 152 Health Centers have mental health teams.
Source: BoF Minas Gerais
Edition: Elis Almeida