The mental health reform of Brazil shifted care from institutions to community services, primary care and residential and social support programmes through the following:
- Negotiation with municipalities and states to replace the beds in psychiatric hospitals for community-based mental health services and psychiatric beds in general hospitals
- Creation of Therapeutic Residential Services for deinstitutionalization of long-stay psychiatric patients
- Expansion of federal financial incentives and technical support to implement community mental health services
- Establishment of initiatives to prevent alcohol and other drugs in schools (campaigns, trainings, guidelines)
- Implementation of health teams for people living on the streets – Programa Consultório na Rua (Healthcare on the streets Programme)
Integration into primary care
- Implementation of Mental Health guidelines to Primary Care.
- Creation of specialized centres to support Family Health teams (NASF) in Mental Health Care and to improve their relationship with other services of the Psychosocial Care Network.
- e-learning tools for primary care workers [“Caminhos do Cuidado” (Care Pathways) trained more than 216000 professionals] and for mental health professionals (about 10.000 participants), between 2014 and 2015.
- Sharing of experiences and expertise between different mental health teams [“Percursos Formativos na RAPS” (Formative Pathways in Psychosocial Care Network) had 1600 participants in 2015].
Focus on recovery
- Creation of transitory residential care units for adults and for children and adolescents, operating 24 hours, 7 days per week to provide continuous care for alcohol and other drug related needs requiring therapeutic assistance and protection
- Creation of the “Going Back Home” Programme, which aims for the social reintegration of people affected by mental disorders through a monthly payment, paid directly to the beneficiary, for a period of one year or more, if the person has not yet been able to reintegrate into society
- Establishment of financial support for local initiatives which promotes employment/income generation and empowerment for people with mental disorders