Presentation
In the process of building and consolidating the SUS (SUS is the Institution responsible for running the Brazilian Public Health Care System), the attention given to mental health can be highlighted as one of the organ’s most successful policies.
Building from an anachronical attention model, centered almost exclusively in admitting patients to psychiatric institutions, the SUS was capable of, in little more than a decade, redirecting the mental health policy to a network of out-of-the-hospital, territory-based care.
The effects of this change are palpable not only in the sanitation field, with the sheer broadening of access possibilities to the treatment of mental health, but they also reach the broader dimension of culture, with a strong influence on society’s perception of madness.
This change made itself felt in the work quotidian of the mental health services that constitute this new model, regarding the CAPs as well as the other tools that constitute the network.
It is worth highlighting, in the consolidation of this policy, the paramount important of the Going Back Home Program, created by Federal Law # 10,708 and sanctioned by President Lula in 2003, which represented the fulfillment of a historical demand from the movement for psychiatric reform in Brazil, and that has been giving a new and positive meaning to the life of users and the families of users of the public mental health system. The program, now completing four years of existence, has already helped more than 2,600 people – who have for years been limited to asylum life – in their return to fully exercised citizenship.
Even facing important initial difficulties (lack of documentation of patients who have been admitted for a long time and an almost absolute loss of their social connections, among other factors), the system made it possible to verify the immediate effects of the Program in the quotidian of egresses from psychiatric hospitals – the rehabilitation aid paid by the Program provides a significant intervention in the buying power of its benefited patients, empowering their emancipation and autonomy.
Another aspect that we would like to highlight is that adhesion to the Program and de-institutionalization should necessarily walk together in the expansion process of the CAPs, of the Therapeutic Residences, of the Culture and Co-existence Centers, of the ambulatories and the General Hospital beds in the cities. This complex task demands from the managers at SUS a permanent and productive articulation with the community, without losing sight of the main goal: the conducting of a responsible therapeutic work with the patients leaving the psychiatric hospital, the respect for each case, and for each person’s pace in readapting with society.
As I willingly highlighted in my acceptance speech, I identify as one of the priorities of SUS, and consequently of my management, the commitment with ensuring the continuity of the Brazilian psychiatric reform.
The book with images of the patients who benefited from the Going Back Home Program, that we now have the pleasure to present, is an attempt to portray in the fullness of its most ample dimension this process of transforming mental health care, a process that shall have reflections not only in the re-dimensioning of the world, but of the quotidian of these citizens as well.
José Gomes Temporão
Head of the Ministry of Health
