Psychiatric Reform in Portugal and Brazil: ‘One Principle, Two Experiences’

The presentation contextualizes the similarities and differences between two processes of psychiatric reform or deinstitutionalization in mental health, in Brazil and Portugal. It is the result of a research conducted by the author in both countries between 2017 and 2020. In Portugal, the main empirical record was a co-operative in the food and housing sector, whose members are people suffering from mental illness, users of the Portuguese public health system. Methodologically, the study was conducted in a participatory-ethnographic way, which guided the theoretical discussions and bibliographical analyses. Theoretically, the concepts of ecology of knowledge and ecology of recognition were inspirational. The findings indicate that in Portugal, the technical-scientific field was the driving force behind the reform, not producing social movements or substitutive services. The lack of public policies motivated the creation of the above-mentioned cooperative. In Brazil, there was a social movement for the anti-asylum struggle. Since the creation of the Unified Health System (SUS, acronym in Portuguese), substitutive services have been created. The problem is that there is insufficient capacity to provide care for all those who need it, due to underfunding and privatizations carried out by neoliberal anti-popular governments.