The trajectory of crack users to the street situation in the perspective of family members.

OBJECTIVES: To understand the family experience regarding the trajectory of crack users for the street situation. METHODS: Qualitative study using the systemic approach as the theoretical referential and the narrative as methodological referential. We conducted interviews with eleven family members of crack users with street situation experience cared for at a community mental health service. We analyzed the interviews using the inductive content analysis technique. RESULTS: The family members understood the trajectory of the crack users for the street situation from two perspectives. One before the street situation process, for which they described a problematic childhood, the presence of stressor traumas/events, vulnerabilities in the family environment, and their family members' encounter with the drug world. Moreover, another posterior to the street situation, for which they narrated the perception of alterations in the users, the discovery of crack use, the deepening of the individuals' relationship with the streets, and the adoption of coping strategies. CONCLUSIONS: It was made evident that the family adopts an explicative model for the behavior of drug use and contact with the streets based on the life history of the crack user family member.

The trajectory of crack users to the street situation in the perspective of family members

Abstract Objective. To understand the family experience regarding the trajectory of crack users for the street situation. Method. Qualitative study using the systemic approach as the theoretical referential and the narrative as methodological referential. We conducted interviews with eleven family members of crack users with street situation experience cared for at a community mental health service. We analyzed the interviews using the inductive content analysis technique. Results. The family members understood the trajectory of the crack users for the street situation from two perspectives. One before the street situation process, for which they described a problematic childhood, the presence of stressor traumas/ events, vulnerabilities in the family environment, and their family members' encounter with the drug world. Moreover, another posterior to the street situation, for which they narrated the perception of alterations in the users, the discovery of crack use, the deepening of the individuals' relationship with the streets, and the adoption of coping strategies. Conclusion. It was made evident that the family adopts an explicative model for the behavior of drug use and contact with the streets based on the life history of the crack user family member.

Resumen Objetivo. Comprender la trayectoria de usuarios de crack en situación de calle desde la perspectiva de los familiares. Métodos. Estudio cualitativo, realizado en un servicio público de salud mental, que utiliza el abordaje sistémico como referencial teórico y la narrativa como referencial metodológico. Se realizó una entrevista en profundidad con cuestión orientadora junto a 11 familiares, y la técnica de análisis de contenido para la exploración de las narrativas. Resultados. Los familiares comprendieron la trayectoria para la situación de calle a partir de dos perspectivas principales: el pasado, donde narraron eventos de la infancia / adolescencia de los usuarios, y el presente, donde contaron específicamente sobre la ocurrencia de la situación de calle. Discusión: Los eventos que justifican el uso de drogas son percibidos como momentos de fragilización, a partir del entendimiento de que el usuario era un "niño-problema". Conclusión. Se evidenció que la creencia familiar puede funcionar como los ajustes para cuidar y mantener la unión y la homeostasis familiar.

Resumo Objetivo. Compreender a experiência familiar sobre a trajetória de usuários de crack para a situação de rua. Método. Estudo qualitativo utilizando a abordagem sistêmica como referencial teórico e a narrativa como referencial metodológico. Foram realizadas entrevistas com 11 familiares de usuários de crack com vivência de situação de rua e atendidos em um serviço de saúde mental comunitário. As entrevistas foram analisadas por meio da técnica de análise de conteúdo indutivo. Resultados. Os familiares compreenderam a trajetória dos usuários de crack para a situação de rua a partir de duas perspectivas. Uma anterior ao processo da situação de rua, onde descreveram uma infância problemática, presença de traumas/eventos estressores, vulnerabilidades no ambiente familiar e o encontro dos seus familiares com o universo das drogas. E uma posterior, onde narraram sobre a percepção de alterações nos usuários, a descoberta do uso de crack, o aprofundamento da relação dos indivíduos com as ruas e a adoção de estratégias de enfrentamento. Conclusão. Evidenciou-se que a família adota um modelo explicativo para o comportamento de uso de droga e contato com a rua baseado na história de vida do familiar usuário de crack.

Where to seek help? Barriers to beginning treatment during the first-episode psychosis.

OBJECTIVE: As decreasing the duration of untreated psychosis has been highlighted as key indicator in relation to improved prognosis, this study aims to identify the access barriers to beginning early treatment of young people in first-episode psychosis (FEP), based on family reports on the experience of perceiving illness and help-seeking. METHOD: A qualitative research was carried out with 12 relatives of 12 young people passing through their first psychiatric hospital admission as a result of their FEP. Depth interviews were used for data collection and thematic content method for data analysis. RESULTS: Barriers to beginning treatment were lack of knowledge and difficulty in recognizing mental illness, lack of knowledge on where to seek specialized treatment, and stigma and resistance to psychiatric treatment. CONCLUSION: It was demonstrated that the family members are protagonists in the search for treatment of young people in their FPE, given that the initiative for seeking treatment came from them.