The professionals’ perspective on the patient discharge process of the Caps-AD: criteria and difficulties

Abstract

The aim was to understand the discharge process of patients at the Center for Psychosocial Care Alcohol and Drugs (CAPS-AD) from the professionals' perspective. The discharge criteria used by them, by the institutions where they worked and the difficulties encountered during the discharge process were investigated. The methodology was qualitative. Sixteen professionals working in the multiprofessional team of five CAPS-AD at São Paulo were recruited from the snowball technique. Data collection was performed by in depth interview, follow by transcription and submitted to content analysis. We observed that there is no standardization and clarity of the discharge criteria. There are important divergences among professionals. When faced with the issue of discharge, professionals consider as criteria: change in the pattern of use of the substance, social reintegration, improvement in psychological functioning and coping skills of the individual and achievement of established goals. The greatest difficulties were the differences in the team, professionals’ omnipotence, difficulties related to the rupture of the bonds, institutional dependence, patient instability and difficulties in health network articulation. The results express the complexity and amplitude of the discharge issue in CAPS-AD. The process is influenced by factors from social, economic, political, subjective and institutional dimensions.