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Madness and Social Change

Autobiography of the Brazilian Psychiatric Reform

  • Book
  • © 2022

Overview

Authors:
  1. Paulo Amarante

    1. National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

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  • Analyzes the Brazilian Psychiatric Reform, one of the world’s largest experiences of deinstitutionalization
  • Discusses the relationship between mental health care and social change, with a special focus on human rights
  • Shows how Brazil developed a large scale model of mental health care based on open doors mental health services

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Table of contents (4 chapters)

  1. Front Matter

    Pages i-xviii
    Download chapter PDF

  2. Introduction: Dimensions of the Psychiatric Reform as a Complex Social Process

    • Paulo Amarante
    Pages 1-12

  3. The “Industry of Madness” Is Denounced: Birth of the Brazilian Psychiatric Reform

    • Paulo Amarante
    Pages 13-45

  4. The Sociocultural Dimension: Concrete Experiences About Production of a New Social Place for Madness and Psychological Suffering

    • Paulo Amarante
    Pages 47-69

  5. Final Considerations and Comments: Health and Psychiatric Counter-Reform or Dismantling the Brazil’s Rule of Law

    • Paulo Amarante
    Pages 71-86
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Keywords

About this book

In this book, the history of the Brazilian Psychiatric Reform is told by one of its main protagonists. In the early 1980s, there were about 80 thousand people admitted to psychiatric hospitals in Brazil, with average lengths of hospital stay of approximately 25 years. The psychiatric reform process that took place in the country was responsible for closing more than 60 thousand beds in mental asylums, most of them characterized by conditions of violence and abandonment.

The Brazilian Psychiatric Reform was inspired by the psychosocial care model introduced by psychiatrist Franco Basaglia in Italy and was marked by the broad participation of social movements, such as the anti-asylum movement and other human rights movements. This process gave rise to a model of mental health care based on open-door territorial mental health services, guided by the principle of treatment in liberty, in addition to other strategies of deinstitutionalization.

More than a proposal to restructureor modernize the mental health care model, the objective of the Brazilian Psychiatric Reform was the construction of a new social place for the diverse and singular subjective experience of madness. By intending to produce new imaginaries, new social representations and new meanings for these experiences, the Brazilian Psychiatric Reform led to one of the larger experiences of deinstitutionalization in the world and to the large scale implementation of a new model of mental health care in which the old asylum-centric paradigm was replaced by a new democratic psychosocial care model. 

Authors and Affiliations

  • National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

    Paulo Amarante

About the author

Paulo Amarante is one of the founders of the movement that led to the Brazilian Psychiatric Reform, and is a Senior Researcher of the Laboratory of Studies and Research in Mental Health and Psychosocial Care at the Sergio Arouca National School of Public Health of the Oswaldo Cruz Foundation (LAPS/ENSP/Fiocruz), Brazil. He holds a Master’s degree in Social Medicine from the Rio de Janeiro State University (UERJ), Brazil; a PhD in Public Health from the Oswaldo Cruz Foundation (Fiocruz), Brazil, with an internship at the Center for Studies and Research in Mental Health in Trieste, Italy; and has done a post-doctoral internship at the Department of Mental Health in Imola, Italy.  Dr. Amarante is the President of Honor of the Brazilian Association of Mental Health (ABRASME), former Vice-President of the Brazilian Association of Collective Health (ABRASCO) and Doctor Honoris causa of the Popular University Madres de Plaza de Mayo, Argentina.

Bibliographic Information

  • Book Title: Madness and Social Change

  • Book Subtitle: Autobiography of the Brazilian Psychiatric Reform

  • Authors: Paulo Amarante

  • DOI: https://doi.org/10.1007/978-3-031-13375-6

  • Publisher: Springer Cham

  • eBook Packages: Medicine, Medicine (R0)

  • Copyright Information: The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022

  • Hardcover ISBN: 978-3-031-13374-9Published: 07 September 2022

  • Softcover ISBN: 978-3-031-13377-0Published: 08 September 2023

  • eBook ISBN: 978-3-031-13375-6Published: 06 September 2022

  • Edition Number: 1

  • Number of Pages: XVIII, 86

  • Topics: Public Health, Clinical Psychology, Health Policy, Psychiatry

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