10
and 2005, the state of Ceará furthered the growth of the Psychosocial Care Centers ’
network and included the city of Sobral.
Casa de Reposo Guararapes coped with an area of almost one million residents,
although it only had one hundred and ten beds. Ambulatory service was poor.
Mental health care changed dramatically after Casa de Resposo Guararapes closed in
July 2001. Such date indicates the transition process from a hospital/asylumoriented assistance model to a decentralized, regionalized approach, with new
equipment and the proposal of rehabilitation and social reinsertion of people with
mental illness.
b)
Domingos Sávio do Nascimento-Alves, M.D. and former Mental
Health Coordinator of the Ministry of Health of Brazil
The Instituto Franco Basaglia mainly aims at developing actions to formulate public
policies which promote and protect the rights of the mental health service users.
In 1992, an innovative project called “SOS Rights of the Psychiatric Patient” was
created, through which mental health care patients, their next of kin and physicians,
among others, could make complaints. At the beginning, complaints on bad and
abusive treatment were more frequent; at present, complaints have changed and
now refer to the exercise of individual rights and the difficulty of people with mental
illness to have access to justice. Such changes entail a progress regarding to the
complaints on services and professionals.
From 1990, the Ministry of Health issued several rules which regulate psychiatric
hospitals practices as part of the Single Health System; promoted the new national
registry of system units, and created the hospital psychiatric care group, which pays
monitoring visits.
Between 1993 and 1994, nine thousand hospital beds were closed and the death rate
in hospitals plunged 12%. Hospitals were replaced by a community service network,
that included different Psychosocial Care Centers (CAPS) and aid centers in the
health basic network. In the recent past years, the Ministry of Health, through the
Psychiatric-Hospital Services Assessment National Program, intervened several
institutions and restructured psychiatric care.
The State’s mental health policy has focused on the humanization of the assistance
of people with mental illness and the defense of their rights.
c)
Luís Fernando Farah de Tófoli, psychiatrist for the Department
of Social Health Development of the City of Sobral
The influence of the Ximenes-Lopes case in the reorganization of mental health care
in Sobral is unquestionable. The Mental Health Integral Care Network in Sobral
(RAISM, for its acronym in Spanish) was implemented on July 10, 2000, which is,
figuratively speaking, the same date on which the Agreement between Casa de
Reposo Guararapes and the Single Health System expired. The Network consists of a
General Psychosocial Care Center, a therapeutic residence, a psychiatric care unit in
a general hospital, and monitoring and teaching modules concerning the family