The de-institutionalization of the mental patients and the alternatives for local caring: models of public policy
University of Coimbra Center for Social Studies Coimbra, Portugal
The process of de-institutionalization of the mental patients has known innumerable obstacles and delays but it finally seems to be starting, as much in Portugal as in Brazil. This paper intends to contribute for a comparative analysis of the processes of psychiatric reform in the two countries, identifying both the sources of resistance and obstacles and factors of progress, political conjunctures and means mobilized in each country to generate a renewed model of caring for mental patients.
It will trace the evolution of policies, identifying their premises and outcomes; identifying care producers and their modes of operation at present; analysing the impact of deinstitutionalization on mental health care and evaluating families' capacity to provide care; and identifying the factors that obstruct or facilitate the implementation of the philosophy of deinstitutionalization
Starting from the theses on the welfare mix, and bearing in mind the specificities of Southern European countries, and particularly Portugal, the study seeks to test the following hypotheses: 1. State action is characterized by weakness and inefficacy; 2. The action of the family and primary social networks is characterized by flexibility and efficacy; 3. Policies show a discrepancy between premises and outcomes; 4. Policies have been following the model of deinstitutionalization, but have not actually put it into practice; 5. Deinstitutionalization entails a burden for families.