title: [Psychiatric reform, federalism, and the decentralization of the public health in Brazil].
abstract: This study examines the relationships between Brazilian psychiatric reform, the adoption of the Centers for Psychosocial Care (CAPS) and the development of the Unified Health System (SUS). The adherence of municipal governments was a variable determinant for the spread of reform, especially due to the continental scale and fragmentation of the Brazilian federation. The article demonstrates the institutional stability of psychiatric reform in Brazil over two decades. The institutional nature of the decision-making process in the public arena has permitted the implementation of new organizational formats through imitation and financial incentives. The psychiatric reform was successful in defending the advantages of CAPS in relation to the asylum and hospital model dominant in past decades. The inductive policies, strengthened and upheld by Law 10.216/2001, transformed the agenda of psychiatric reform, limited to pioneering cities in a national public policy.
authors: Departamento de Ciências Sociais, Escola Nacional de Saúde Pública, Rio de Janeiro. nilson@ensp.fiocruz.br
authors: Nilson do Rosário
authors: Ndo R
authors: Costa
authors: Sandra Venâncio
authors: SV
authors: Siqueira
authors: Deborah
authors: D
authors: Uhr
authors: Paulo Fagundes da
authors: PF
authors: Silva
authors: Alex Alexandre
authors: AA
authors: Molinaro
mesh_terms: D001938:Brazil; D035082:Federal Government; D018166:Health Care Reform; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D011057:Politics; D011635:Public Health Administration