A ação territorial do Centro de Atenção Psicossocial (CAPS) enquanto indicativo de sua natureza substitutiva
The present dissertation aims to investigate the possibilities of action of a 
Psychosocial Care Center (CAPS) in relation to its territory. The theoretical reference 
provided by the Italian Democratic Psychiatry and by the experience from Santos of a 
mental health program introduces services which act as a replacement for the madhouse 
model as they promote a rupture concerning the psychiatric hospital work. The territory 
becomes a strategic actor to the transformation of the relationship among psychiatry, 
insanity and society. As a group of social references, of intrapersonal functioning codes 
which confront a social imaginary and reality that include or exclude the different, the 
territory is a stage of exercise to the cultural transformation in relation to the 
phenomenon of madness. 
In the context of SUS (Sistema Unico de Saude), the CAPS, created in order to 
replace the continuous treatments in psychiatric hospitals, is included in the category of 
health services by the ministerial decrees, and is spread nationally as a place of 
reference and treatment for people who suffer from psychiatric disorders. The 
production of substitutive services related to SUS challenges the services to break with 
a trajectory of a reform reduced to a technical-assistance dimension, in order to 
approach again to the ethical, conceptual, judicial and social transformations which are 
part of the Brazilian Psychiatric Reform movement. Therefore, it is necessary to go 
beyond the traditional clinic view, and include in the praxis different ways of knowing 
the patients, families and territory. 
A CAPS in the state of Rio de Janeiro was taken as a field of investigation in 
order to verify how its everyday praxis is organized, investigating the possibilities of its 
actions, either inside the institution or in relation to the territory, strengthen 
transformations in the ways of conceiving and dealing with insanity. A participant 
observation was used as well as semi-structured interviews with some professionals 
who work in the CAPS. The investigation emphasizes the importance of making the 
everyday work reach an understanding of the transformations it can operate.
Protagonismo e subjetividade: a construo coletiva no campo da sade mental
This paper is a reflection on the origins as well as conceptual and historical bases of the production of subjectivity by the subject that is considered insane. The importance of the concept of mental alienation in the shaping of the social place of insanity in modern society is analyzed in parallel with the constitution of an alienated subject, incapable of subjectivity or desire: a non-subject of medicalized insanity. Then, after an elaboration about the genealogy of subjectivity, a reflection is presented on the current practices in the field of mental health that aim at the collective construction of the subject of insanity no longer as an alienated subject but as a protagonist, which means a new social relationship with insanity.
[An adventure in the insane asylum: the life of Franco Basaglia].
The process of change in the mental health field and psychiatric reforms bear a close relationship to practical and theoretical issues stemming from Franco Basaglia's experience. This article is intended as a reflection on Basaglia's career, stressing the main concepts and theoretical references he worked with and seeking to trace the unique nature of his contributions to the current project for de-institutionalizing psychiatry. Basaglia produces a break by profoundly challenging psychiatric knowledge and institutions, thus allowing for a new epistemological framework (a framework that was thus also new in relation to culture and mental health care) in dealing with insanity. Based on the observation that Basaglia's work is little known, this article attempts to revisit his thinking, highlighting the unique nature of his contributions and stressing the need for a better understanding of his work by those who are devoted to the field of mental health and social institutions.