GOVERNANCE DILEMMA, DIAGNOSTIC INFLATION AND MEDICALIZATION IN YOUTH DETENTION CENTRES IN BRAZIL

Abstract

The article analyzes the utilization of psychoactive drugs by youth offenders in social-educational facilities in Brazil. It describes the guidelines of the national public policy to mental health care for young offenders. This article results from three case studies in the States of Rio Grande do Sul (RGS), Minas Gerais (MG), and Rio de Janeiro (RJ). The central hypothesis is that governance regime could explain psychiatric medicalization decision. The cross-sectional data resulted from a sample of medical records and interviews with key informants. The article shows that RJ has strengthened the health professional’s decision, but it could not be associated with high prevalence of psychoactive drugs utilization. In RJ, verticalization has responded to national policy requirements with the implementation of clinical protocols that limited the use of medication. The State of MG demonstrated alignment with the guidelines of federative cooperation in mental health care for young offenders. The penalties for infractions have produced different medicalization decisions for female adolescents. National policy guidelines had influenced mental health care in two cases analyzed. Psychotherapies and rehabilitation actions are the first-line interventions implemented in the states of MG and RJ.