|Home|Articles|Contact Us|Site Directory|Privacy Policy|Visit Our Online Store|

National Empowerment Center - Articles

Brazil's social movement to close mental asylums

By Richard Weingarten

Add This Page To Your Social Bookmark Service Share This Article With A Friend Print This Page

Of all the Latin American countries, only Brazil has a national grassroots consumer movement. As a long-time Brazil-watcher, I've been very interested in the social movements that have grown there since the late 1970s that have given voice to the aspirations of ordinary Brazilians. I had lived in Brazil in the late 1960s and early 1970s when the military government was at its most repressive and any political activity outside narrowly-defined channels was outlawed and prohibited. Then, as the military government loosened its grip in the late 1970s, social movements such as the Liberation Theology's Base Communities, the Indigenous Peoples' Defense of the Amazon Rainforest, the Movement to Protect Street Children, and others started to appear across that large and diverse country.

I first heard about the consumer movement in Brazil unexpectedly one afternoon while I listened to a National Public Radio program about a consumer radio program in São Paulo, Brazil called "Wacko Radio." Several months later I read an article by Judi Chamberlin in which she mentioned meeting Brazilian "users" at a conference in Europe. (Brazilian consumers call themselves "users".) I called Judi in Boston to see if she had any information on Brazilian users. She kindly gave me the name and address of Graca Fernandez, a user spokesperson from Rio de Janeiro. I wrote to Graca, informing her that I worked in the mental health field as a consumer-provider and spoke Portuguese, and that I wished to come to Brazil to meet her and her user colleagues. After a couple of months of exchanging letters and faxes, we agreed that the best time for me to come was in November, 1997 when the biennial meetings of the Movement to Close Mental Asylums was scheduled to take place.

Soon after I arrived in Rio, Graca took me to meet Dr. Fernando Ramos, the Director of the Pinel Mental Hospital. The 'Pinel' as it was popularly called was connected to the Franco Brasalglia Institute (IFB), a leading research, training, and cultural dissemination center named after the visionary Italian psychiatrist who was instrumental in closing mental hospitals in Italy. The IFB was where Graca worked as vice president and where a newly created day hospital also was located.

When I asked Dr. Ramos why the Movement to Close Mental Hospitals began in Brazil and no other Latin American country, he responded that it was totally unforeseen. It began, he said, when a senator from Rio de Janeiro named Paulo Delgado introduced a bill in the Brazilian Congress in 1989 that would close long-term mental asylums and create "alternative" community services. Wealthy private interests who owned the asylums and operated with government funding mounted strong opposition. But at the same time popular support for the bill also sprang up from all parts of the country, Dr. Ramos said. The Movement to Close Mental Asylums grew out of this popular support, he said. Now several years later the bill is still tied up in Congress while its supporters struggle to have the bill passed.

A few days after speaking with Dr. Ramos, Graca and I traveled on a chartered bus to the meeting in Porto Alegre, a large city in the far south of Brazil. The trip was scheduled to take 24 hours but actually took 32 hours! On the trip I learned that when Brazilians go for a 20-minute rest stop they are more likely to take an hour and a half eating a full course sit-down meal. This celebratory approach to travel translated on the bus into Samba rhythms and songs that went late into the night. Before I was feeling too sorry for my ordeal, I heard that a busload of delegates from the far northern Amazon state of Para was on the road three days and nights before they got to the meeting! With this kind of spirit and stamina, I knew that the Brazilians were in it (the Movement) literally for the long haul.

In Porto Alegre I discovered that the Movement was made up not just of users. Mental health professionals, called tecnicos in Portuguese, were allies, as were many family members. According to Graca, the Movement was primarily a Movement of the lower-middle class. The middle classes were not interested, she said. Their ill relatives went to private clinics for therapy and medication and lived at home with their families who kept their illness a secret because of the stigma attached. When I asked Dr. Ramos about the stigma factor, he said it wasn't as harsh as in the United States. Brazilians were a tolerant people he said, and pointed to a popular night-time soap opera which had a user as one of its main characters.

More than 800 delegates arrived in Porto Alegre on a rainy day, thanks to El Nino, for the five-day meeting. The delegates chose one of five subgroups to work in for the first three days of the meeting. The subgroups were organized around the topics of Legislation and Citizenship, Culture and Ethics, Work, Adult Services, and Adolescent and Children's Issues. Each session had the task of putting together resolutions that the whole meeting would ratify, amend, or reject in the plenary session the last two days of the meeting.

I participated in the subgroup on Work as an International Delegate. Much of the discussion revolved around the formation and operation of social cooperatives which were seen as the most effective and humane way of introducing users into the labor market. The subgroup discussed and gave their support to a recently-proposed federal bill, also put forth by Senator Paulo Delgado, that would create "social cooperatives" expressly for people with disabilities and not just mental disabilities. The subgroup also passed a resolution that would be approved by the plenary session to have the federal government provide pensions to people with psychiatric disabilities. As it was, users received a mere $100 dollars from the federal government each month to live on. As the cost of living in Rio de Janeiro was not very much below the cost of living in a North American city, this sum was really insufficient.

The Legislation and Citizenship subgroup passed resolutions calling for continued support of the bill to close mental asylums and looked to municipal and state governments to pass laws outlawing mental asylums and putting community services in their place. This subgroup also called for the development of a primer that would delineate in simple language the human rights of people with psychiatric disabilities. These would be based on the Civil Code and other documents that provided for citizen rights.

When I expressed some skepticism that all the resolutions would be acted on, Graca said that the main benefit of the meeting was that it allowed users from all over the country a chance to get to know one another, and by holding the meeting, the emergent social movement affirmed itself.

When I returned to Rio, I visited two day hospitals that were well-run and innovative. One was based entirely on the arts. I was lucky to go there one afternoon for a "talent show." The talent displayed was impressive but more impressive was the easy way the users and non-users (staff and community friends) sang, danced, and mingled with each other. They treated each other with respect and affection.

The other day hospital was run out of the Franco Brasalglia Institute. I visited a room where a cooperative was housed. The users made and bagged popcorn and shelled nuts to sell on the busy nearby streets. I also was shown a well-equipped television studio and some user-run television programs that have been aired on the federal government's "Health Channel."

My three weeks in Brazil went by like a dream, the kind of dream that leaves one energized and uplifted. Having wanted for many years to play some role in Brazil again, the trip was very satisfying. Once back in Connecticut it took me several days to settle into my job. I missed the sun, and the warmth of my new Brazilian friends. I thought of devising ways to persuade my reserved New England friends and colleagues to take time to enjoy life's small pleasures-as the Brazilians did-bringing a little bit of Brazil back to Connecticut.