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Prospects for mental health policy in Brazil.

This article is published in Open Access under the Creative Commons Attribution license, which allows use, distribution, and reproduction in any medium, without restrictions, as long as the original work is correctly cited. The November edition of CSP features three articles in the Thematic Section on progress and setbacks in mental health policy in Brazil 1,2,3. A reading of the three papers in the section provides clear evidence: Brazil was successful in building a wide network of community-based psychosocial care services, spread all across the country, called the Centers for Psychosocial Care (CAPS in Portuguese) with their various modalities and types. There were just 148 in 1998, but by 2014 they had reached 2,209. This network should be a source of pride for every Brazilian, given the country’s diversity and continental size. How, we need to ask ourselves if the development of this services network has guaranteed better mental health care in Brazil. Are our patients living better today? In addition to the implementation of services, have we succeeded in changing society’s view of individuals with mental disorders, ensuring greater acceptance and their inclusion in our cities’ daily lives? In other words, has the Psychiatric Reform also led to the reduction of stigma against users of mental health services? Judging by the countless stories we hear and collect around the country 4,5,6,7, yes, without a shadow of a doubt, our psychiatric patients are living better today. But do we really have sufficient information on those who lack access to these services? Another extremely important element addressed by the three articles and that relates to the opening questions is that despite the initiative’s success, we are in the midst of a what amounts to an interrupted process – interrupted before it was strong enough not to run the risk of serious damage. That is why a Thematic Section on Brazil’s mental health policy is so timely and necessary at this juncture in the country’s history. We could categorize this section with the three articles in three moments: “what was achieved”, “what remains to be achieved, and where we should make progress to achieve what is missing”, and “the risks we are facing”, emphasizing why the currently impending setback is so dangerous and discouraging, coming as it does under the guise of “reorientation”, “resetting the compass”, “scientific evidence”, etc. Prospects for mental health policy in Brazil