Rio de Janeiro’s mental health deinstitutionalization policy: progress, challenges, and effectiveness

Abstract

How has the public policy of mental health deinstitutionalization evolved in the municipality of Rio de Janeiro? Based on the findings of Escossia e Alves (2018), which highlight an incipient monitoring culture at the municipal level and challenges in measuring the impacts of this policy, this article analyzes, using quantitative and qualitative data, the indicators related to the implementation of Residential Therapeutic Services (SRTs), the performance of Psychosocial Care Centers (CAPS), and the reduction of psychiatric beds. The results indicate progress in monitoring, such as increased CAPS coverage and the expansion of psychosocial care services. However, significant challenges remain, including discrepancies between financial resources allocated and outcomes achieved, as well as limitations in data systematization to assess effectiveness and social reintegration. Furthermore, the COVID-19 pandemic exposed weaknesses in planning and the policy’s adaptability. Thus, it is concluded that monitoring mechanisms need to be improved to better align efficiency with effectiveness and to integrate, as far as possible, dependent and independent variables into the process. Another key finding is the need for clearer and more accessible communication of policy outcomes to society, ensuring that this information reaches beyond technical audiences.