Replacement of the Brazilian mental health national coordinator with a former director of one of the dreaded psychiatric hospitals in Latin America

December 21st, 2015

The new Brazilian minister of health has removed the federal coordinator of mental health Roberto Tykanory, historical leader of the Brazilian mental health reform, and has nominated as new national coordinator a psychiatrist representing the most conservative psychiatry based on asylums. This nomination triggered national and international support to defend the reform and the movement “luta antimanicomial”.

You may read below the letter of protest sent to the Minister of Health of Brazil by former directors of the World Health Organization and Pan American Health Organization, as well as their advisers in Asia, South Africa, Italy, UK, USA and India.


Letter to the The Minister of Health of Brazil, Dr Marcelo Castro

20 December 2015

Subject: Replacement of the mental health national coordinator with a former director of one of the dreaded psychiatric hospitals in Latin America

The undersigned, all mental health professionals from around the globe, among them many who have closely followed the admirable efforts that Brazil has made in mental health care over the years, have learned that those efforts are at risk of coming to an end.

Your Excellency, we are aware that it is the Government of Brazil that dictates the policies that guide the process of the Psychiatric Reform in the country, but our concern for the future of the Reform is born from our profound debt to your country for having taught us so much over recent years how to convert an archaic system of care to one that is observant of human rights, is inclusive of all relevant mental health parties, and is scientifically based.

Beginning with the pivotal role it played to achieve the Caracas Declaration (1990), which orients the restructuring of psychiatric care in all countries of the Region and beyond, continuing with the organization of the Region-wide meeting in 2005 that formulated the Principles of Brasilia, and culminating with the active involvment in the Directive Councils of the Pan American Health Organization to promote the Mental Health Reform in all countries of the Americas, has become a world leader in implementing it.

It is important to emphasize that the efforts Brazil has made in the last two decades to advance its mental health system are completely in line with WHO recommendations to shift from hospital to community-based care. In addition, the mental health system developed by Brazil is also in line with the UN Convention on the Rights of Persons with Disabilities, a Convention that your country is supporting with its signature and ratification.

We trust that our unanimous voice in expressing our deep concern for halting the Psychiatric Reform will be heard. We are persuaded that both the World Health Organization and the Regional Office of the Pan American Health Organization will be ready to collaborate with Brazilto maintain its excellent achievements in mental health care: the unobstructed continuation of the Psychiatric Reform will be for the benefit of Brazil and the countries in which we work.

Benedetto Saraceno, Gulbenkian Professor of Global Health, NOVA University, Lisboa, Portugal

Itzhak Levav, Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel

José Miguel Caldas de Almeida, Head, Department of Mental Health NOVA University of Lisbon, Portugal

Emiliano Albanese, Director WHO collaborating center for training and research in mental health. Department of Psychiatry University of Geneva, Switzerland.

Michaela Amering, Professor of Social Psychiatry, University of Vienna, Austria

Victor Aparicio, President Presidente Asociación Asturiana de Neuropsiquiatría y Salud Mental, España

Corrado Barbui, Professor of Psychiatry, University of Verona, Italy

Thomas Bornemann, Director, the Mental Health Program, The Carter Center, Atlanta, USA

Nick Bouras, Director Maudsley International, King’s College, London UK

John Bowis, Former UK Health Minister and Health Spokesman in the European Parliament

Giovanna Del Giudice, President Permant Conference for World Mental Health (CoppersaMM), Italy

Giuseppe Dell’Acqua, Forum Salute Mentale, Italy

Julian Eaton, Senior Mental Health Advisor, Christian Blind Mission (CBM)

Angelo Fioritti, Health Commissioner, Bologna, Italy

John Jenkins, Chief Executive International Mental Health Collaborating Network, UK

Helen Killaspy, Professor of Rehabilitation Psychiatry, University College London, UK

Michael King, Professor of Primary Care Psychiatry, Division of Psychiatry (Faculty of Brain Sciences), University College London, UK

Arthur Kleinman, Director Harvard Asia Center, Harvard, USA

Stan Kutcher, Professor st Dalhousie University, Canada

Nasser Loza, DirectorBehman Psychiatric Hospital, Cairo, Egypt

Crick Lund, Director: Alan J Flisher Centre for Public Mental Health Department of Psychiatry and Mental Health, University of Cape Town, South Africa

John Mahoney, Consultant in Mental Health WHO Liberia and formally Head of Mental Health and Social Care for England, Department of Health, United Kingdom

Nino Makhashvili, Head of Mental Health Resource Center, Ilia State University, Tbilisi, Georgia. Director of GIP-Tbilisi, Georgia

Ambrogio Manenti, Senior Adviser to WHO, Cairo Egypt

Hugo Mercer, Professor Universidad Nacional Arturo Jauretche and Universidad Nacional de San Martin, Argentina

Roberto Mezzina, Director WHO Collaborating Centre for Research and Training, Trieste, Italy

Harry Minas, Head, Global and Cultural Mental Health Unit, Director, Melbourne Refugee Studies Program, The University of Melbourne, Australia

Soumitra Pathare, Co-ordinator Centre for Mental Health Law and Policy Indian Law Society, Pune, India

Jean Luc Roelandt, WHO Collaborating Centre for Research and Training, Lille, France

Franco Rotelli, Chairman Health Committee, Regione Friuli Venezia Giulia, Italy

Sashi Sashidaran, Professor Institute of Health & Wellbeing, University of Glasgow.

Deya Saymah, adviser WHO Occupied Palestinian Territories, Gaza.

Stelios Stylianidis, Professor of Social Psychiatry Panteion University, Athens, Greece

Rangaswami Thara, Director Schizophrenia Research Foundation, Chennai, India

Robert Van Voren, Chief Executive of Federation Global Initiative on Psychiatry and Vice-President of WFMH, The Netherlands

Lakshmi Vijayakumars, Director SNEHA, Chennai, India

Henrik Wahlberg, Senior Consultant, Psychiatrist, Karolinska, University Hospital Huddinge, Stockholm, Sweden


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