Teresina gains two therapeutic residences.

“It’s very good here. We have more freedom and we are more united,” says Irene Silva*, 64, who has lived in a therapeutic residence for 10 years. Diagnosed with psychosis and severe depression, the patient was hospitalized at the former Meduna Sanatorium twice. She even lived on the streets until she was admitted to one of the first therapeutic residences implemented by the State Government, through the State Health Department.

Therapeutic residences are part of a system of assisted living facilities, intended for patients discharged from psychiatric hospitals after two years or more of hospitalization and without family ties, as well as for people with mental disorders in conflict with the law, aiming to provide a more humane alternative for care.

“With the therapeutic residence, I discovered a new way of living. I can go to mass, do the shopping, and there are also some outings, whereas at the Meduna (Sanatorium) I just lay there taking medication,” said Irene*.

The life stories of these patients demonstrate that social reintegration is a viable alternative in psychiatric treatment. Another good example is told by patient Carlos Pereira*, 59 years old. Coming from the prison system, he spent 15 years in the Major César Penitentiary, two years in the Areolino de Abreu Hospital (HAA) until he was transferred to a therapeutic residence located in the southern zone of Teresina, where he has lived for three months.

“Back in Areolino, we had recreation twice a week. We could play ball and everything, but here at the residence it’s much better. We have caregivers day and night who help us properly with household chores,” said Carlos Pereira*.

In addition to outings and physical activities, patients also receive treatment from the neighborhood's Psychosocial Care Center (Caps). Currently, Piauí has ​​five of these residences. Of these, four are located in Teresina – three of which are state-run and one run by the Municipal Health Foundation – and one in the municipality of União.

The Secretary of State for Health, Francisco Costa, says that the progress is very positive. “At the beginning of 2015, we faced the problem of overcrowding at the Areolino de Abreu Hospital (HAA) and also a high demand at the Valter Alencar Penitentiary Hospital (HPVA). After an understanding with the Secretary of Justice, the Court of Justice, and mediated by the Public Prosecutor's Office, we realized that removing patients from hospital inpatient care would be the best way forward. Therefore, we opted for a policy of expanding the availability of places through therapeutic residences,” he explained.

With the installation of these two new residences, the Health Department will benefit 16 patients with mental disorders from the prison system. "We will be able to provide more humane care to these patients, strengthening their reintegration into society," says the secretary.

He further emphasizes that these residences represent a very significant advancement because they allow for the transfer of patients who have spent many years institutionalized in those places to a more humane community-based care setting, which also frees up beds at the HAA (Hospital de Apoio ao Atendimento).

Patients who will be transferred to their new residences have already begun the adaptation process at the Psychosocial Care Centers (CAPS) in Teresina. Prior to this, they were evaluated by a team of mental health professionals within the prison system, composed of psychologists, psychiatrists, social workers, nurses, and occupational therapists. This is a deinstitutionalization program, proposed by the Ministry of Health, which involves the effective return of these patients to the community environment with the vision and mission of humanizing psychiatric care.

Therapeutic residences

In Teresina, the two new residences are expected to open: one in the Três Andares neighborhood and the other in São João. Each will serve eight patients. Currently, twenty-one people are already being served in the three units located in the Porenquanto and Monte Castelo neighborhoods.

Furthermore, the State Government intends to decentralize this service to other regions such as Parnaíba, Picos, Floriano, and Valença.

The services offered in therapeutic residences show that this is a successful alternative in psychiatric treatment. The major difference is that the residence, being a dwelling, is a home intended for patients who have spent a long time institutionalized in a psychiatric hospital.

Once there, patients are enrolled in social programs implemented by the government, proposed by the Unified Health System (SUS) and the Unified Social Assistance System (SUAS), such as community centers, cultural and leisure spaces, education, among others. Their stay at the neighborhood's Psychosocial Care Center (CAPS) will be outlined in a linear therapeutic project.

*fictitious name