De Carvalho Amarante PD; Guimarães Torre EH. A constitução de novas práticas no campo de Atenção Psicosocial: análise de dois projetos pioneros na Reforma Psiquiátrica no Brasil. [The making of new practices in the field of psychosocial care: analysis of two pioneering projects in Brazil’s psychiatric reform.] Saúde em Debate (Health in Debate) 2001 May-August; 25(58):26-34.

Objectives: To analyze the documentary record underlying two pioneering services in Brazil ’s Psychiatric Reform. To understand the new practices in mental health and to examine the theoretical foundations of new forms of care for persons afflicted with mental health problems and in crisis situations.

Methodology: Analysis of documentary and bibliographic material to compare two projects.

Results: The article analyzes the projects that started with the creation of the Professor Luis da Rocha Cerqueira Center for Psychosocial Care in São Paulo in 1987 and the first Center for Psychosocial Care in Santos in 1989. The article points out the similarities and differences between the two projects.

The first project was based on two central ideas: de-hospitalization (influenced by the American model) and cultural transformation (influenced by the Italian movement). The proposal implied the creation of a non-bureaucratized, intermediary network between the hospital and the community, linked closely to the community and served by a multi-professional group. Mental illness would be construed as existing within the larger body of collective health and considered within its macro and micro-social contexts.

The second project emphasized the need to deconstruct the social conception of insanity and to instill health more than to render care. This project opened the debate to the citizenry at large. The proposed therapeutic project consisted of providing care for an individual, making that person responsible both for oneself and for requests made upon him or her, avoiding a situation of abandonment, and attending to any crises.

Both projects sought not simply the humanization or modernization of patient care in the area of mental health, but also transcendence of the traditional model of psychiatric care.

Conclusions: The findings should help professionals and technical personnel in mental health who maintain an interest in new knowledge, policies and actions aimed at de-institutionalizing the population of insane asylums and building incentives for social participation by people with mental disturbances.

Copyright 2007 University of New Mexico