Objective:

To conduct a theoretical reflection on the historical trajectory of care offered to patients with mental suffering in Brazil based on the National Mental Health Policy.

Content synthesis:

This is a theoretical reflection from the analysis of the achievements of the Brazilian Psychiatric Reform regarding care devices available in the Unique Health System for individuals with mental health demands, as well as recent changes in the National Mental Health Policy that urge deploying the already established psychosocial care model. A series of events that go against the model of care based on the social reintegration and promotion of the autonomy of individuals were observed, which shows worrying indications of return to the asylum and the exclusionary model.

Conclusions:

This study intends to foster debates about the direction of mental health care in Brazil, alerting to the need for popular participation in health policy decisions and encouraging the permanence and improvement of the psychosocial model in mental health.

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