History of psychiatry management at Instituto Municipal Nise da Silveira: creative and cultural actions that impact asylum deconstruction in the Brazilian society

Abstract

Asylum deconstruction has been a theme that has brought, both in academia and society, several discussions that have emphasized the struggle for the deinstitutionalization of madness and for the “end of asylums”, as well as the historical constitution of health and mental illness. In this trajectory of deinstitutionalization of madness, the Instituto Municipal Nise da Silveira (IMNS) has acted on several fronts, ranging from the architectural restructuring of the institute, as well as the creation of devices capable of building a new vision of mental illness in society. This study sought to understand the history of psychiatry management in Brazil and the Nise da Silveira Institute, as well as to analyze how the Institute’s creative and cultural actions impact on the deconstruction of the need for clinical hospitalization in closed institutions in Brazilian society. This article joins the interpretative paradigm, since it understands that the phenomena are socially constructed, and are constituted from the interactions of social agents. It was decided to use in-depth interviews, document analysis, and ethnographic-inspired methods, seeking to be part of the experience lived by mental health users. The results suggest that the restructuring movement intensified with the Psychiatric Reform in Brazil, whose proposal was the reformulation of the mental health treatment policy in the country. Therefore, IMNS has acted on some fronts, it can be seen that internal and external actions were included in the strategic planning, called “inside” and “outside” actions in the institutions.