Recovery, citizenship, and psychosocial rehabilitation: A dialog between Brazilian and American mental health care approaches

Abstract

Over the past 30 years, the Brazilian psychiatric reform, based on the anti-asylum social movement and the psychosocial rehabilitation model of care, transformed radically the country’s system of mental health care. Even though tremendous gains were made, people with serious mental illness continue to have limited access to citizenship. In the United States the recovery movement has enhanced the central role of people with serious mental illness as an active and responsible agent in their recovery process, encouraging a more collaborative role for service users, but, still, there are challenges to citizenship. This article first identifies commonalities between these two movements, central to mental health advances in the two distinct cultures of Brazil and the United States. Then, though celebrating the cultural differences between the two societies, the authors consider the possibility of cross-fertilization and propose a set of suggestions that could help both countries to overcome the remaining barriers to social justice for those living with mental health issues. From the American recovery movement, the authors learn that society can and must make adaptations to allow people with mental health disorders to live as citizens regardless of the symptoms they might manifest. From Brazil, mental health workers can use solidarity as a tool to create inventive solutions for those with a mental health disorder to live as citizens, regardless of the symptoms they might manifest.