Paths and detours in the trajectory of the Brazilian psychiatric reform

This article looks at the principles and guidelines of the Unified Health System as well as the current situation and the limitations and possibilities of Brazilian mental health policy. Based on a review of national and international government documents and the scientific literature from 2015-2020, the study observed positive advances in mental health. However, the psychiatric reform has experienced setbacks, and the balance of mental health care has swung towards hospital-centered treatment. These changes have impeded the implementation of the Psychosocial Care Network, as well as the development of therapeutic practices and strategies focused on the person’s experience, their daily life and their relations with the health promotion network. By questioning the supremacy of medical-psychiatric knowledge in the treatment of “mental illness” in the public health care system, the psychiatric reform cleared a path for the construction of new ways of addressing psychological suffering. These gains are currently at risk, making a wider debate on the current trends in mental health care in Brazil essential.

STUDY LITERATURE REVIEW ADVOKASI KEBIJAKAN KESEHATAN MENTAL

Mental health is a condition that affects a person's thinking, feeling, and protecting yourself so you can succeed in your daily life. However, the amount of stigma and ignorance of the rights of mental health sufferers makes support groups want to carry out policy advocacy. The author conducted a study literature review on mental health policy advocacy that has been done by previous researchers to find out various programs or ways to advocate for mental health management. This SLR shows that advocacy efforts can be carried out by distributing content on social media, communicative discussions, and health literacy tools. Increasing mental health support for policy advocacy will make the government wiser towards mental health policies and also facilitate health services for people with mental disorders.

History of psychiatry in Nepal

The history of psychiatry as a discipline in Nepal has been poorly studied. We have attempted to summarise historical landmarks to explore how it began and its evolution over time in relation to contemporary political events. Although Nepal has achieved several milestones, from establishing a psychiatric out-patient department with one psychiatrist in 1961 to having more than 500 psychiatric in-patient beds with 200 psychiatrists by 2020, the pace, commitment and dedication seem to be slower than necessary: the current national mental health policy dates back to 1996 and has not been updated since; there is no Mental Health Act; the number of psychiatric nurses and in-patient psychiatric beds has increased only slowly; and there is a dearth of professional supervision in rehabilitation centres. Thus, despite making significant progress, much more is required, at greater intensity and speed, and with wide collaboration and political commitment in order to improve the mental health of all Nepali citizens, including those living in rural areas and or in deprived conditions.

Mental health law in Nepal

During the past three decades Nepal has gone through series of reforms to address the mental health needs of the Nepalese population by promulgation of an exclusive National Mental Health Policy and related Strategic Action Plan. Small but significant improvements have been achieved in Nepal with regard to mental health policies and plans. This article discusses the evolution of mental health policies in Nepal and analyses the challenges to be overcome for their effective implementation.