Historical evolution of the mental health approach in brazil: from the psychiatric reform to the current days

Objectives: to describe the evolution path of the management of mental health from the Psychiatric Reform to the current days; to identify the strategies and alternative programs to the hospital model and highlight the changes that took place in the transition from the asylum paradigm to the extra-institutional one. Method: this is an integrative literature review. A survey of journals was carried out in the Bireme websit ‒ VHL (Virtual Health Library) ‒ on May and June 2011, including the databases LILACS and SciELO. Only papers whose full texts were available were explored. In order to find these studies, the descriptors “mental health”, “community psychiatry”, “public policies”, “deinstitutionalization”, and other ones pertinent to the theme were used. Results: the Psychiatric Reform has been developing in Brazil since the 1970s. Thus, the mental health assistance has been ruled by the change from the asylum paradigm to the psychosocial mode. For this, programs and services which are an alternative to psychiatric hospitals were created, and they have resulted in a decrease in thousands of psychiatric beds in the country and the closing of many psychiatric hospitals. Conclusion: this is a complex work, which demands singular approaches to meet the various needs of the patients. It demands, also, that these programs are developed in a continuous and dynamic way and with frequent adjustments, in order to maintain the achievements in accordance with the improvement the patients present, besides the training of mental health professionals. Descriptors: community psychiatry; mental health; asylums; deinstitutionalization. RESUMO Objetivos: descrever a trajetória evolutiva do manejo dispensado à saúde mental da Reforma Psiquiátrica até os dias atuais; identificar as estratégias e programas alternativos ao modelo hospitalar e destacar as mudanças ocorridas na transição do paradigma asilar para o extra institucional. Método: trata-se de uma revisão integrativa da literatura. Foi realizado um levantamento de ...