Deinstitutionalizing Psychiatry in Brazil: Risks of Removing the State’s Responsibility?

Abstract

This study analyses the deinstitutionalization process that resulted from the Psychiatric Reform movement, discussing, in particular, the destinations indicated by families of people with mental disturbances, based on changes in the functions of the state in this process. The study is based on a bibliographic review. For better contextualization of this issue, some aspects considered relevant were mentioned. Concerning the historic trajectory of the Brazilian family, and more specifically, of the family in the context of mental health, which shifts the roles and places of the different family groups in the community insertion of people with mental disturbances, the study found that it is not enough to close asylums or reduce the number of psychiatric beds, if the meanings of the apparatus at the family, community and social levels are not first modified. Moreover, for the psychiatric reform to be effective, the family must be seen as an essential agent in the transformations of the perception of madness, and be included in a responsible manner in the process of care, receiving support and sharing attributions with the state and the community.