Abstract
Brazil, since the approval of Law 10.216 of 2001, has prioritized this emphasis and has announced the government's interest in implementing a psychiatric reform, however, the coexistence of asylums and community models has been blatant of the current support to the mental health in the country. The purpose of this article is to present an analysis of the vicissitudes of this process, taking as a case study the offer dynamics of these services, in the capital of Ceara, in the northeast of Brazil, in the period from 2007 to 2016. For this, we conducted a documentary study based on the quantitative data of mental health assistance services that are generated through the National Health Establishment Register (CNESnet, by its Portuguese acronyms) and the Tabnet application; available by the Department of Information Technology of the National Health System (Datasus, by its Portuguese acronyms). For the period under analysis, we noticed an increase in the supply of community-based services with the surge of six new services, hiring of seventy specific professionals for the substitutive care, concomitant to the closure of the activities of three psychiatric hospitals with asylum services. However, we identify that the legislation of substitute services is problematic when it comes to its constitution and perpetuation of the asylum model. Finally, we found that economic factors were the preponderant factors for the closure of hospitals and those remnants increased their offers of available beds and their invoicing.
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