Regress of the psychiatric reform: the dismantling of the national Brazilian mental health policy from 2016 to 2019

Abstract

The article analyzes the setbacks in the National Mental Health Policy in the period between 2016 and 2019, based on a study of the norms issued by the federal government and documents of a public nature, and on the study of data from the Brazilian Ministry of Health regarding the mental health network of the Unified Health System. All normative documents that make up a set of ‘reorientations’ of the Policy were evaluated, in addition to those that directly affect it, including opposing positions issued by the executive, legislative and judicial branches. The analysis indicates the first effects of these changes in the Psychosocial Care Network, such as encouraging psychiatric hospitalization and financing for therapeutic communities, actions based on a prohibitionist approach to issues related to the use of alcohol and other drugs. The analysis of the management data allows to affirm that there is a tendency of stagnation in the pace of implantation of community-based services. This study aims to contribute to a better understanding of the fundamentals and the strategic direction of the changes, which imply a setback in the Psychiatric Reform guidelines, aiming to broaden the debate on the forms of resistance to the dismantling of the National Mental Health Policy.

mental health policy; psychiatric reform; Unified Health System; health financing; psychosocial attention