A história da política de saúde mental no Amazonas: da institucionalização à reforma psiquiátrica

OBJECTIVE: This article describes the context of Mental Health Policy in Brazil and Amazonas, analyzing the history of this policy in the state in connection with the country's economic, political, and social system. MATERIAL AND METHODS: The qualitative research used oral and documentary sources. Actors involved in the Psychiatric Reform Movement and their strategies to record the history of Mental Health and Psychiatric Reform in Amazonas were interviewed. RESULTS: Brazil is internationally recognized for prioritizing deinstitutionalization in mental health, promoting psychosocial care networks that guarantee citizenship and inclusion for people with mental suffering. In Amazonas, the initiatives of the 1980s were stagnant in the 1990s, being resumed in 2000 with debates on Psychiatric Reform. The mobilization resulted in the State Mental Health Policy, approved in 2003 by Resolution CES No. 037, aiming to replace psychiatric hospitals with community services. The state bill on Mental Health No. 3,177 was only sanctioned in 2007, and the first Psychosocial Care Center (CAPS) was opened in Parintins (2005) and Manaus (2006). CONCLUSION: The period analyzed covers the period from the 19th century to the present. Despite the advances, the sources indicate that mental health policy in Amazonas was influenced by the political agendas of state and municipal governments and conflicts between stakeholders, compromising the implementation of services and overloading emergency psychiatric care.