From patient to clinical case: an ethnography with psychiatric inpatient care releases

Social Science contributions to the understanding of psychiatric care have highlighted the passage from person to patient as being crucial to the moral career of the mentally ill. In this article another moment relevant to a discussion on illness and social identity is investigated, namely the passage from patient to clinical case. Socio-anthropological fieldwork was conducted between 2007 and 2010 with users of a care network after release from psychological internment, their relatives and neighbors. It highlighted not only the administrative categories that professionals in the network used to designate patients, but also those given by other villagers. Some villagers are considered doidos ("loonies") without having been admitted as "patients" to the local inpatient facility. Others are "users", registered at an outpatient service; or "clients", when they are frequent users. Some are called bonequeiros ("troublemakers"), "nervous", or barulhentos ("noisy crackpots") because of their behavior in public. Finally, by becoming the object of comments by people on the street, they also become "cases," which are eventually discussed at the mental care facilities, thus becoming "clinical cases." Mental disorders are as relevant to the management of a stigmatized social identity as surnames and nicknames.