Tudo como dantes no Quartel D'Abrantes: estudo das internaçöes psiquiátricas de crianças e adolescentes através de encaminhamento judicial

The present dissertation aims to carry out a comprehensive analysis of the process of compulsory referral to inpatient psychiatry hospital of male children and adolescents due to juridical mandates from the Rio de Janeiro Judicial Court for Children and Adolescents), from 1994 to 1997. These referred inpatients are compared with the other inpatients of the same psychiatric facility in the same period, that entered the psychiatric wards under request of their families or referred by other units of the local medical system. The number of patients referred by juridical means have been on increase in the last years, and represented one third of all new male inpatients enrolled in the facility under analysis in 1997. The author debates the appropriateness of the present system of direct juridical referral, that eludes the evaluation of professionals with expertise in mental health, as well the current restrictions posed upon the whole process of hospital discharge, that always depends on further juridical clearance. The theoretical and documentary inputs for the dissertation are as follows: a thorough review of bills and laws on children and adolescents throughout different historical contexts and a short account of the recent history of the unit under analysis (UHVR). This latter, after 1995 (with the cessation of the activities of FCBIA – a major facility devoted to the same population), became the sole public facility specialized in the care of mentally handicapped children and adolescents, and, thereafter, the sole destination of juridical mandates. The selection criteria of judges and the medical staff of the unit were compared using quantitative data, an in-depth interview with a key-judge working in the field, and material from a focus group putting together health professionals of the unit. We expect the dissertation could contribute to define sound principles of referral, management and care for the target population, advancing proposals for a redefinition of medical and juridical current procedures – especially, their so far poor and conflictive relationship –, to reduce the social exclusion of the disadvantaged Brazilian children and adolescents that have perpetrated criminal offences. The broad frame we would like to insert both juridical and medical procedures is of an effective (re)educational process, that could actually rehabilitate Brazilian youth.