Experts by Experience, Demedicalization and the Emergence of Alternative Approaches to Mental Health Care: Gaining Autonomy & Medication Management (GAM) in Brazil

In Ana Paula Barbosa-Fohrmann & Sandra Caponi, Latin American Interdisciplinary Perspectives on Bioethics and Disabilities. Springer Nature. pp. 17-30 (2023)
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Abstract

This chapter addresses an alternative mental health care strategy to the hegemonic medicalizing logic: Gaining Autonomy & Medication Management (GAM) (Originally, in French: La Gestion autonome de la medication. In English, the name was changed to be adapted to the acronym GAM.). Developed in Canada in 1993 following the wishes of users and ex-users of mental health services, it is characterised by the appreciation of their experiences and knowledge, usually neglected in psychiatric clinical practice, especially with regard to their drug treatments. This approach was introduced in Brazil almost 20 years later through a partnership between Brazilian and Canadian researchers. The principles were maintained but Brazilian GAM has undergone important transformations, aimed at adapting to the new context. We seek to explore the differences between the Canadian and Brazilian GAM guides, with an emphasis on the specificities of GAM application in the Psychosocial Care Network (RAPS). This focuses on providing qualified information about psychiatric drugs to users, critical reflection on their rights in health services and the participatory establishment of an action plan, aimed at promoting their autonomy and improving their quality of life. Finally, in spite of advances following Brazilian Psychiatric Reform and the emergence of initiatives such as the GAM in Brazil, we question the limits of the debate on demedicalization in the current Brazilian context.

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