A história da Política de Saúde Mental do Amazonas: a reforma psiquiátrica e sua estruturação

Abstract

The work aims to historically analyze the structure of the Mental Health Policy in the Amazon, focusing on the Psychiatric Reform that took place mainly in Manaus. The Psychiatric Reform Movement in the Amazon began in the late 1970s by a group of psychiatrists and psychiatric professionals Cologne Eduardo Ribeiro Hospital, which were inspired by the ideas of the Psychiatric Reform. Ideas that made possible the emergence of a Mental Health Policy in Brazil, from the questioning of the crazy forms of treatment and a proposal of de-institutionalization, culminating in Law Paulo Delgado project in 1989. Law that redirects the mental health care, focusing on offering treatment in community-based services, and provides for the protection and rights of people with mental disorders, but does not establish clear mechanisms for the phasing out of asylums.In Amazonas, state law No. 3177 was enacted only in 2007 and still did not succeed in ensuring the implementation of substitute services in sufficient numbers to meet the demand for mental health, especially in the capital of Manaus. The methodology used was documentary research and oral history. Interviews were conducted with managers and professionals who work or worked in the mental health of the Amazon. The paper is organized in the form of two papers: The first is devoted to the survey of the history of the Mental Health Policy Amazonas State since the late nineteenth century and seeks to describe the context of the Mental Health Policy in Brazil and in the Amazon Movement of the period of psychiatric reform until the publication of Psychiatric Reform Law. The second focuses on the description and analysis of the maintenance process of the Implementation Policy Psychosocial Support Centers - CAPS and other alternative services as well as in the psychiatric deinstitutionalization process in the state, the identification of the main actors and their strategies in the execution of Psychiatric Reform in the Amazon. The two articles bring elements to the understanding of mental health policy and the structuring of the psychiatric reform in the state. We conclude that the history of mental health in the state is the product of the relationship and conflicts between the actors and the management of policy, bringing losses for the effective realization of the psychiatric reform.