Foucaultian devices and mental health in Uruguay

Abstract

The discourses referring to the need for changes in mental health care, which modify the logic of care focused on asylum, since the post-war period in Europe have become established as the orientation of public health policy. However, in Latin America and more precisely in South America, mental health reforms began to be considered in the public debate in the 1980s. The following article aims to explain the particularities of the change in mental health care in Uruguay, through from the foucaultian concept of device. We identify that the concept of device and the typologies that Foucault (2004/2006) raises in the seminar Security, territory and population, allow us to trace the heterogeneity that constitutes the field of mental health in Uruguay. A strategy of power over life in anatomical-political terms, made it possible to establish the asylum as the main institutional support for mental health, although it is currently questioned as established by the Uruguayan mental health law of 2017. The closure of asylum and monovalent structures and community care according to Law 19,529 (Uruguay, 2017), expresses regimes of freedoms that must be ensured for those who suffer from mental health problems, in turn these freedoms pose costs for society as a whole. In this sense, the security device acts as an intelligibility grid on the changes in mental health since the 1980s, where a heterogeneous and regulated field is configured through the production and management of freedoms under the supposed protection of a collective interest.

In addition to investigating the concept of the foucaultian device and its typologies applied to mental health care in Uruguay, it will be shown how the problem of security is modulated by considering the community as an exemplary government space in mental health. Through prescriptive texts (Foucault, 1984/1986) such as the National Mental Health Plan of 1986 and the mental health Law approved in 2017, mental health is identified as a heterogeneous field and constituted based on a biopower strategy, which we can analyze through the notion of device.