Self-Management of Medication, a Participatory Intervention Research in Brazil

The project GAM-BR (Self-Management of Medication, Gestão Autônoma de Medicamentos – Brasil) is an ongoing participatory intervention research since 2009. In the context of the partnership between Brazil and Canada under... [ view full abstract ]

The project GAM-BR (Self-Management of Medication, Gestão Autônoma de Medicamentos – Brasil) is an ongoing participatory intervention research since 2009. In the context of the partnership between Brazil and Canada under the umbrella of ARUC (Alliance Internacionale de Recherche Universités-Communauté), this multicentric project translated and adapted to the Brazilian reality the "My Self-management Guide" - a Canadian instrument dedicated to enhance the autonomy of users of mental health services in the use of psychopharmaceuticals. In Brazil, the use of psychopharmaceuticals is a blind spot of the Psychiatric Reform. Choices are often imposed on users: sometimes medication is not available, while in other occasions it is the only offered treatment, so that overmedication is not uncommon. These constraints limit the exercise of citizenship, restrict the rights of the users and damage the work in mental health services. The Guide GAM-BR tries to nourish the debate on the theme, favouring the emergence of new strategies to deal with the difficulties. The Brazilian version of this instrument was collectively built by users of public mental health services, their families, workers, and university researchers in heterogeneous research groups. At the same time, these groups allowed exploring and opposing different perspectives on the concrete experience of using psychiatric drugs.This process affected simultaneously the users' experiences, the conduction of work in the mental health services, the managing practices and the academic activities. The adaptation of the Guide showed that its construction could also be a therapeutic work:research and caring were intertwined. The Guide is still in use nowadays. It is employed in the so-called GAM groups, that are very similar with respect to their management and objectives. Therefore, in the GAM groups everyone is co-responsible for the production of knowledge and for its critical evaluation, leading to more inclusive practices.