Sufrimiento psíquico y salud pública.
Una reseña del proceso para el pasaje del manicomio biomédico, a una ética de la atención comunitaria: el caso del Hospital Nacional Psiquiátrico Dr. Roberto Chacón Paut, Cartago, Costa Rica, 1952-2022
Keywords:Public health, Mental health, Community psichiatry, Social inequalitiesm Costa Rica.
In this paper, we make the discussion about the approach to mental suffering presented by patients who are treated at the Day Center for Mental Health. The brief is based on a project called ``Specialized Community Care Device of the Dr. Roberto Chacón Paut Hospital'', which was presented to the Medical Management of the Caja Costarricense del Seguro Social (CCSS) in 2021. This was developed by two psychiatrists in conjunction with a number of specialists from the institution. In its management, had have participated psychiatry, nursing, psychology, nutrition, social work, and occupational therapy professionals. To understand the emergence of this initiative in the current context, it is necessary to conduct an epistemological, ontological, and ethical discussion regarding public health policies and practices for clinical care, in Costa Rica and other parts of the world, as well as a debate on different approaches, such as interventional biomedical, antipsychiatry, community psychiatry and psychoanalysis. In this case, an integral vision is defended about the subject, taking into account its needs, its social relations, as well as its material and subjective conditions of existence, so that it chooses to understand its suffering, from the space closest to its daily life: the community. This aims to contribute to the discussions on conditions that promote well-being and psychological distress, the history of psychiatric institutionality, clinical approach, and community care in mental health. This article is part of research on the history of the hospital, which is carried out in conjunction with the University of Costa Rica (UCR) and the CCSS, specifically at the Social Research Institute (IIS) and the Dr. Roberto Chacón Paut Hospital. It is based on a methodology that integrates a review of scientific literature, an analysis of the discourse of the newspaper library, and interviews.