O artigo faz uma revisão da reforma psiquiátrica brasileira nas décadas de 1980 e 1990, até a promulgação da Lei de Saúde Mental, em abril de 2001. Aborda os conceitos básicos que distinguem o processo atual de iniciativas anteriores. Apresenta os antecedentes do processo atual; os conceitos e valores que caracterizam a reforma brasileira; as experiências inaugurais de Santos (SP) e do Centro de Atenção Psicossocial (Caps) Luiz Cerqueira em São Paulo; a iniciativa de revisão legislativa, com uma análise da lei finalmente aprovada; a tendência das políticas públicas de saúde mental no período aqui abarcado, incluindo as portarias 224/92 e 106/2000 do Ministério da Saúde; a situação atual do processo de substituição asilar no país e a reestruturação da assistência no município do Rio de Janeiro.
This article presents a brief history of the Brazilian psychiatry reform from the 1980's and 1990's to April 2001, when the Mental Health Law was finally signed. The author discusses the basic concepts that characterize the present condition of the reform as opposed to those of previous initiatives. He also presents a general view of the preceding events to the present process; the concepts and values that characterize the Brazilian reform; the first experiments in São Paulo; the legislative initiative with an analysis of the new law; the different public policies in relation to mental health during the period analyzed with a copy of the Ministry of Health Ordinances 224/92 and 106/2000; the present condition of the de-institutionalization process in the country and the restructuring of the assistance system in the municipality of Rio de Janeiro.
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