Psychic suffering or mental disorder?: Clinical-political impasses between demand and reception

Abstract

This article is derived from the post-doctoral research conducted in cooperation between educational institution and the State Secretariat of Health between 2021 and 2023, starting from the issue of “non-adherence to treatment” in mental health. With the objective of collecting elaborations from the teams of the Psychosocial Care Network (RAPS) regarding the daily clinical-political impasses at the moment of rupture of the Psychiatric Reform and the outbreak of the COVID-pandemic19, the article has as methodology to analyze issues that emerged in case discussions with professionals, under the foundations of Lacanian-oriented psychoanalysis. From the researchers’ inquiry regarding “difficult cases” (suicide attempts, self-mutilation, “self-boycott” and “non-adherence to treatment”), it is extracted, as a result, the difference between the reception/treatment of mental distress and the classification/withdrawal/medicalization of mental disorder. The impossibility of listening and interdisciplinary construction generates a “care vacuum”, replaced by actions of recollection in philanthropic institutions, among other forms of intervention that feedback demands in the field of mental suffering. The article points out, as a conclusion, the need for qualification of the teams that make up the RAPS with clinical-institutional/territorial supervision, among other implementations. It brings, as a contribution to RAPS, the main supports of the psychoanalytic clinic: the transfer, in its face of resistance and the drive of death.