Itinerários e processos de cuidado junto a crianças com autismo e suas famílias no programa de saúde mental infantil Brincando em Família

Abstract

The purpose of this research was to investigate the articulations that can be built on child mental health care, therapeutic and care itineraries, public policies and autism, a phenomenon with a significant increase in diagnoses in contemporary times, presented in studies as a matter of public health , with recognized etiological complexity, due to the existence of multifactorial factors in its origin. Thus, the general objective of the research was to understand the care processes built with children with autism and their families in the mental health program Brincando em Família and their relationship with the care itineraries followed. The specific objectives were: to reconstruct the care itineraries carried out by children with autism and their families in search of child mental health support; to analyze how care is provided through play with children named as autistic and their families in the mental health program Brincando em Família, in order to understand the links made with Brincando em Família and its relationship with the care processes. The theoretical framework was psychoanalytic in orientation through the contributions of Donald Winnicott, Luís Claudio Figueiredo, René Kaës and contemporary authors articulated with discussions in the psychosocial care area. This is a qualitative research of multiple cases in which reports from the hostesses, reception forms, attendance sheets and other recorded materials of the Program were used to produce the data, in addition to interviews with the participants. Regarding the participants, who attended the space with demands related to autism, two families were chosen. The thematic analysis strategy guided the in-depth analysis of the data and the results, were presented and discussed in three chapters. The study demonstrated, through therapeutic and care itineraries, an intense family movement through different health services in order to find a space for reception and treatment, identified as insufficient for the growing demand in the autism area. It was found that there are peculiarities in the care offered at Brincando em Família, in its unique context of receiving children and their families together. Brincando em Família allowed children interactions through free play with the involved presence of the team. These are some characteristics that led the Program to become a favorable environment for the emotional maturity of these children. At the same time, the space proved to be a place of family support, that encourage reflections on the singularities and relationship with each child, beyond labels, which could crystallize questions about him. Furthermore, the challenges faced by these families, in search of attention to their children's mental health, and the importance of public policies were identified, given a scenario in which services are still insufficient, considering the growing demand for care for specificities related to autism.