Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 16 nº 2 - Apr/Jun - 2019

Original Article Imprimir 

Páginas 38 a 46


Sociodemographic profile of adolescents deprived of their liberty in the interior of Sao Paulo State

Perfil sociodemográfico de adolescentes privados de libertad en el interior del estado de Sao Paulo

Perfil sociodemográfico de adolescentes privadas de liberdade no interior do Estado de Sao Paulo

Autores: Fernanda Augusta Penacci1; Carmen Maria Casquel Monti Juliani2; Guilherme Côrrea Barbosa3

1. Doctora in Collective Helth by the Paulista State University Júlio de Mesquita Filho (UNESP). Medical College of Botucatu (FMB). Botucatu, SP, Brazil
2. Free-Teacher in Nursing. Teacher of the Nurse Department of the Paulista State University Júlio de Mesquita Filho (UNESP). Medical College of Botucatu (FMB). Botucatu, SP, Brazil
3. Doctorate in Psychiatry. Assistance Professor and Doctorate by the Nurse Department of the Paulista State University Júlio de Mesquita Filho (UNESP). Medical College of Botucatu (FMB). Botucatu, SP, Brazil

Correspondência:
Fernanda Augusta Penacci
Fundaçao Centro de Atendimento Socioeducativo ao Adolescente. Unidade de Atençao Integral à Saúde do Adolescente
Praça da Monçao, nº 653 - Centro
Iaras, SP, Brasil. CEP: 18775-000
(ferpenacci@gmail.com)

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Keywords: Adolescent, Institutionalized adolescents, Public health.
Palabra Clave: Adolescente, Adolescente institucionalizado, Salud Pública.
Descritores: Adolescente, Adolescente institucionalizado, Saúde Pública.

Abstract:
OBJECTIVE: Describe the sociodemographic profile of the adolescent female population deprived of liberty in the interior of the State of Sao Paulo.
METHODS: Compedium of a PhD thesis in collective health, whose cross-sectional study was carried out with secondary data in the two Centers for Socio-educational Assistance for Women in the city of Cerqueira César, State of Sao Paulo. 374 adolescents were analyzed in the age group from 12 to 21 years old of age, from January 2015 to February 2016. A description of the population was performed by means of summary measures: median, minimum and maximum and percentage estimates. For statistical analysis SPSS® software version 21.0 was used.
RESULTS: The adolescent's mean age was 17 years old, with the predominance of brown skin color. It was observed that 69.8% of the adolescents have elementary education and school dropout was 92%. Few adolescents were employed (21.4%) before entering the Foundation and most of them had passages through the Guardianship Council (64.7%). The average family member is of four people; 53% of them live with their parents and 31.4% have a stable union. The average family income was R $ 1,576.00. The Regional Network for Health Care 12 concentrates the majority of adolescents.
CONCLUSION: There is a demand for speed of the public policies and cohesion with the needs of the female population, associated with the affirmation that the programs for the adolescent's care, in general, keep them distant and passive of their notions of health, education, personal and social development.

Resumen:
OBJETIVO: Describir el perfil sociodemográfico de la población adolescente femenina privada de libertad al interior del Estado de Sao Paulo.
MÉTODOS: Resumen de tesis de doctorado en salud colectiva, cuyo estudio transversal fue realizado con base en datos secundarios de dos Centros de Atendimiento Socioeducativo Femeninos en el municipio de Cerqueira César, Estado de Sao Paulo. Fueron analizadas 374 adolescentes en la franja etaria de 12 a 21 años incompletos, en el periodo de enero de 2015 a febrero de 2016. La muestra fue descrita a través de diferentes parámetros como: mediana, mínimo, máxima y estimación de porcentajes. Para análisis estadístico fue utilizado el Software SPSSr versión 21.0.
RESULTADOS: La edad media de las adolescentes fue de 17 años de edad, con predominancia del color de piel pardo. Se observó que el 69,8% de las adolescentes poseen enseñanza fundamental y la evasión escolar fue del 92%. Pocas adolescentes ejercían actividad remunerada (21,4%) antes de entrar en la Fundación y la mayoría posee paso por el Consejo Tutelar (64,7%). El promedio de miembros en la familia es de cuatro personas; 53% de ellas viven con los padres y el 31,4% poseen unión estable. La renta familiar promedio fue de R$1.576,00. La Red Regional de Atención a la Salud 12 concentra a la mayor parte de las adolescentes.
CONCLUSION: Hay necesidad da celeridad de políticas públicas y cohesión con las necesidades de la población femenina, asociadas con la afirmación de que los programas de atención a los adolescentes, en general, las mantienen distantes y pasivas de sus nociones de salud, educación, desarrollo personal y social.

Resumo:
OBJETIVO: Descrever o perfil sociodemográfico da populaçao adolescente feminina privada de liberdade no interior do Estado de Sao Paulo.
MÉTODOS: Resumo de tese de doutorado em saúde coletiva, cujo estudo transversal foi realizado com base em dados secundários de dois Centros de Atendimento Socioeducativo Femininos no município de Cerqueira César, Estado de Sao Paulo. Foram analisadas 374 adolescentes na faixa etária de 12 a 21 anos incompletos, no período de janeiro 2015 a fevereiro de 2016. A amostra foi descrita através de diferentes parâmetros como: mediana, mínimo, máxima e estimativa de percentuais. Para análise estatística foi utilizado o Software SPSSr versao 21.0.
RESULTADOS: A idade média das adolescentes foi de 17 anos de idade com predominância da cor de pele parda. Observou-se que 69,8% das adolescentes possuem ensino fundamental e a evasao escolar foi de 92%. Poucas adolescentes exerciam atividade remunerada (21,4%) antes de entrarem na Fundaçao e a maioria possui passagens pelo Conselho Tutelar (64,7%). A média de membros na família é de quatro pessoas; 53% delas vivem com os pais e 31,4% possuem uniao estável. A renda familiar média foi de R$1.576,00. A Rede Regional de Atençao à Saúde 12 concentra a maior parte das adolescentes.
CONCLUSAO: Há necessidade da celeridade das políticas públicas e coesao com as necessidades da populaçao feminina, associadas com a afirmaçao de que os programas de atendimento aos adolescentes, em geral, as mantém distantes e passivas de suas noçoes de saúde, educaçao, desenvolvimento pessoal e social.

INTRODUCTION

We all go through the adolescence phase, and each experience, whether positive or negative, is in accordance with the conceptions and perceptions derived from the family, social and health environment.

The phase of adolescence is permeated by several transformations that are considered normal to every individual. It is a transitional period and the challenges faced by adolescents would be developmental challenges, including adaptations to puberty-related physiological and anatomical changes. They involve the integration of sexual maturation into a personal model of behavior, that is, the progressive withdrawal of parents and family and the establishment of an individual, sexual and social identity through relationship with their partners, using a skill enriched individual development and potential development for occupational and developmental activities1.

The search for personal identity is one of the most decisive psychosocial commitments for adolescents. He has a need to stand out in his family and peer group, to be distinguished and endowed with his own personality. At this stage of the life cycle he seeks to make sense of life and to understand what surrounds him. To do so, you must learn to accept yourself and others, strengthening your ego2.

Behaviors developed during adolescence are often determined by the social and economic environment in which adolescents develop, which are often unsafe and unfavorable, and actions are therefore required to ensure that societies and their health systems respond adequately to the needs. of health and development of adolescents3.

On the other hand, the insertion of female adolescents in infringing acts is relevant. Thus, it is necessary to enter the second theme that brings aspects related to deprivation of liberty. Once an offense described as a crime or misdemeanor is committed, the competent authority may apply to the adolescent a socio-educational measure. This has a predominantly pedagogical character, with the sole concern of educating and resocializing the adolescent accused of committing an offense, avoiding their recurrence, according to the Child and Adolescent Statute4. The measure of detention is the most rigid, depriving liberty for up to three years and is applied in the event of a serious offense, threat or violence to the person, reiteration in the commission of other serious offenses and repeated and unjustifiable non-compliance with the previously imposed measure. Already, the measure of provisional hospitalization is applied before the court decision and lasts for a maximum of forty-five days. The sanction of detention is a measure of deprivation of liberty with a term of up to three months. It will be determined by the competent authority in cases of non-compliance with a previously applied socio-educational measure5.

The work of listening and accompanying adolescents deprived of their liberty allows us to know aspects of history and life context that point to issues quite different from those that seem to constitute the social imaginary. These are young people who have in their life trajectory a long series of situations of personal and social risk, in which suffering violence seems to be an almost indispensable requirement for the practice of violence6.

In the State of Sao Paulo, the Center for Adolescent Socio-Educational Care - CASA Center, is the institution responsible for applying socio-educational measures to adolescents who committed an infraction, in accordance with the guidelines and norms provided for in the Child and Adolescent Statute (ECA) and other applicable national laws.

The lack of publications that characterize social and demographic conditions of adolescents deprived of their liberty encouraged us to study this relevant theme and, to better contextualize the issue, two contents were required: the peculiarities of the adolescent phase and aspects related to deprivation of liberty. Thus, the study is justified by its social and epidemiological importance, besides being original, innovative and comprehensive, since it encompasses the entire population of female adolescents deprived of liberty in the interior of the State of Sao Paulo.

Knowing aspects of a multidimensionality of factors involving the population of adolescents attended at the only two CASA Foundation Centers in the interior of the State of Sao Paulo becomes relevant. As involvement with the offense is considered a growing social phenomenon and information about the little-known girls deprived of liberty, the knowledge coming from the research assumes great importance.


METHODS

Cross-sectional study based on secondary data from two women's Socio-Educational Care Centers (CASA) located in the Cerqueira César Township, in the state of Sao Paulo. The CASA Anita Garibaldi has the capacity to serve 56 adolescents aged 12 to 21 years incomplete in compliance with sanctions with a maximum stay of up to 90 days, provisional hospitalization with an average stay of 40 days and hospitalization, with an average of stay of 15 months. The CASA of Cerqueira César has the same capacity for care and age as the previous one, but only meets the hospitalization measure, with an average length of stay of 15 to 18 months7. Both have been in operation since July 2007. Data collection was conducted from January 2015 to February 2016 with the adolescents who were already in the Centers and those who were admitted in the period described in order to obtain a bank. of data, which totaled a sample of 374 adolescents. Data were collected from the adolescent health folder, the psychological care folder and a CASA Foundation system used by the multiprofessional team to launch the care, as well as referral to the judiciary to assess compliance with the socio-educational measure.

A description of the population was performed by means of summary measures: median, minimum and maximum and percentage estimation, which were analyzed using the SPSS ® software version 21.0. To obtain the data, an application was filed at the Research and Documentation Center of the School for Vocational Training of CASA/SP Foundation obtaining approval. The project was submitted to the Ethics and Research Committee of the Botucatu School of Medicine and was approved on 12/02/2014, with the Certificate of Presentation for Ethical Appreciation-CAAE 38539614.8.0000.5411.


RESULTS

Of the 374 folders and multiprofessional reports surveyed, there was greater involvement of adolescents in offenses, with an average age of 17 years, and the self-declared predominant skin color at admission to the institution was brown with 58.1%, followed by white with 30, 4%. Regarding education, Table 1 shows that 32.4% of adolescents have incomplete elementary school, while 37.4% have completed elementary school. Another finding is that 24.9% of adolescents have incomplete high school and only 5.3% have completed high school, where the distortion between age and grade is noticeable.






Regarding social conditions, 21.4% of the adolescents had paid work before their admission to the CASA Foundation. Regarding pregnancy, 16.4% of them said they had only one child, a phenomenon that should be considered in understanding their experiences. Regarding the involvement with alcohol and other drugs, it was found that 7.2% of adolescents were already hospitalized in other institutions for addiction treatment. Data indicated that 11.9% of adolescents reported attendance by Institutional Hosting Service and 39.6% of adolescents reported participating in the Bolsa Familia Government Program. Regarding the passage by the Tutelary Council, the contingent was significant with 64.7%. Adolescents and families culminated in 55.9% of follow-ups by the Specialized Social Assistance Reference Centers (CREAS) and the Social Assistance Reference Centers (CRAS).

Regarding the context of living conditions, 53% mentioned living with their father and mother, with an average of four family members. The average gross family income, including the amounts received through the Bolsa Família Program, was R $ 1,576.00. Using as a parameter the ranges of Classification Criteria Brazil8 show that most belonged to class C2. It was observed that 31.4% of adolescents live in a stable union and 37.2% have a family history of disease.

The origin of the female adolescent population of the present study encompasses the entire interior of the State of Sao Paulo, and, for better visualization of the results, the Regional Health Care Networks (RRAS)9 were used as a reference for the division of municipalities, according to Table 4. RRAS 12 followed by RRAS 13 concentrates most adolescents in compliance with socio-educational measures, with 22.73% and 21.39% respectively, ie, almost half of the population studied. It should be considered that they are more populous municipalities compared to the others. In RRAS 12, the municipality of Sao José do Rio Preto represented 7.22% (27) of the adolescents.






In exceptionality, the Women's Centers served teenagers from Sao Paulo and Guarulhos because there are no vacancies at the Call Centers located in these municipalities. However, the primacy is the compliance of measure in the same municipality of residence or in the Center closest to the family home. Adolescents from other states were also assisted such as Mato Grosso do Sul with 2.95%, Bahia with 0.80%, Minas Gerais with 0.53%, Paraná with 0.27% and Espírito Santo with 0.27%.


DISCUSSION

It was found that most of the young offenders reach the civil and criminal age of majority during the fulfillment of the measure. It also means that adolescents commit infringing acts later, considering the average age of 17 years.

Affirmative action policies are a source of encouragement in the search for equal opportunities for these young brown women, who are majority in the CASA Foundation. The configuration of racial, color and gender inequalities were historically constructed in Brazilian society, and the social movements conducting the constituted rights for the inclusion of black women in education, in the labor market and health still make a lot of sense in the face of the gap between women and men, especially if they are black10.

When we take into account schooling, it is clear the poor performance or dropout in basic education. Among the many factors, negative school experience emerges in the literature as one of the most significant predictors of serious infraction involvement in adolescence. School variables overlap with family variables in the official explanation and the explanation given by the adolescents themselves for their involvement with the offending activity. Overall, adolescents in conflict with the law have poor performance and interest in school and high dropout rates. For adolescents who become pregnant, there is also the possibility of early school leaving under stimulated and supported, sometimes pressured to contribute to family income. From this way, children and adolescents begin a cycle of repetition and eventually drop out of school. The work operates as a conflicting mechanism with the school system, promoting lags and exclusion. As school grades progress, the rates of age-grade distortion and dropout rate increase3,11-12.

Regarding the predominant economic characteristics of adolescents, let us consider a discussion about the population for which socio-educational measures are intended, since the offenses aren't only committed by adolescents from low-income families. We observe that the practice of crimes occurs in all social classes and the social response is that it is different for each case13-14.

By the time a child arrives at a shelter, there has been a long process of neglect, abandonment and violence. For some time this family has been struggling to provide, care for, welcome and preserve. In addition, this process is largely permeated by feelings of low self-esteem, often deeply held beliefs about their incompetence in this parenting relationship, poor prospects for the future, and lack of resources to reverse the situation15.

A significant number of families benefit from the Bolsa Família Social Program. However, according to data from the Brazilian Institute of Geography and Statistics (IBGE), the average income of adolescents is above the average income of the Brazilian population, which is R$ 1,113.0016.

Social policies constitute a subset of public policies related to actions that determine the standard of social protection implemented by the state. They relate to the distribution of social benefits to reduce structural inequalities arising from the trajectory of socioeconomic development, usually in the areas of education, health, social security, housing, sanitation, etc., and executed under the responsibility of the State17.

A significant number of adolescents are assisted by the Guardianship Council. It will take action whenever there is a suspicion of threat or violation of the rights provided for in the Statute of the Child and Adolescent, and may be brought by any member of society at any time by denouncing the fact. The actions of the Guardianship Council (and the other members of the "Child and Adolescent Rights Guarantee System") must always be directed "in favor" of the child / adolescent in the sense of their full protection10. However, being a public sphere does not mean that it will solve all democratization problems or prevent the violation of rights.

The assistance of adolescents and their families by CREAS and CRAS is of fundamental importance for the diagnosis of the determining causes of the infractional conduct and for the possible solution of the problems. There is also a need to involve the entire social assistance network to understand and elaborate a situational and individualized diagnosis of the adolescent.

Regarding family issues, most of the adolescents assisted by the CASA Foundation live with their parents. We observed that a group of adolescents reported stable union and currently there is the possibility of new family configurations.

In the context of the offending adolescent, there has been a recurring practice of blaming the family for the situation of infraction, especially in relation to the most socially vulnerable families and those with a "unstructured" family organization, contrasting with the idea of the existence of an ideal family model, adequate to moral and social standards. It is important to highlight that before belonging to such a family, these adolescents come from an unequal society, which excludes them from several basic social rights, making it impossible for the second time, these young people to constitute themselves as citizens of equal rights18.

The presence of the family is of paramount importance during the adolescent's resocialization process, but it is inserted in a certain geographical region, often making it impossible to carry out visits to monitor compliance with the socio-educational measure. There are women who provide for their families and care for their children. Others are without a situation of imprisonment, which makes the visit unfeasible. This is discussed and reflected during adolescent care by the multiprofessional team. However, the strengthening of the family bond is maintained through correspondence and telephone calls.

In other words, there are situations that the family is a risk factor for entering the Center, due to the involvement with crime. Their participation in the socio-educational process, even if postulated by the adolescent, should be weighed in the face of affective bonds and the adolescent's opinion, or excluded, as indicated by the multiprofessional reference team.

In the family context, the risk factors for the outbreak of crime are mostly related to the violent behavior of the parents, as well as physical violence, abandonment, neglect and severe punishments applied by the parents themselves19. Therefore, the family stands out as a risk and protection factor for adolescents.


CONCLUSION

The findings evoke the need to invest in new studies on the thematic approached, as well as the expansion of knowledge that can assist in the construction of public policies and effective actions in accordance with the particularities of this population group.

It was evidenced that the adolescents with 17 years of age are the majority and, therefore, close to the age of majority and the criminal jurisprudence. But regardless of age, the factors that lead an adolescent to become an offender are often complex and varied involving family, school, community, drug contact, and peer affiliation with delinquent behavior.

The continuity of schooling is important and should be supported by the social assistance network, both in the insertion of the adolescent and the effective school monitoring. This aims to improve living conditions and even opportunities for paid work.

In the care of adolescents, it is up to the Institutions to strengthen youth protagonism, favoring protection factors, contributing to the possibility of resignification in their lives.

Even with the distant family, due to the geographical location of many municipalities, the bond with the adolescent needs to be reestablished and made possible. Mechanisms should be created that inhibit recidivism in infringing acts and the strengthening of family ties. Important extract from families accompanied by CRASS and CREAS should be considered. It isn't only the teenager who needs to be strengthened, but also the family.

As the origin of adolescents is predominantly from RRAS 12 followed by RRAS 13 it is appropriate that these regions make an effort to make a diagnosis of the situation and foster discussions involving the entire social assistance network about the involvement of adolescents in offenses, listing the reasons or possible circumstances, forms of expression and the roles of these women in offenses. One has to look at the graduates of the socio-educational system.

In the context of public health, there is a need for the speed of public policies and cohesion with the needs of the female population, compelling the affirmation that adolescent care programs, in general, keep them distant and passive in their notions of health, education, personal development. and social.


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