Política antimanicomial e medida de segurança no Brasil: uma análise crítica do tratamento penal da loucura à luz da Resolução nº 487 do Conselho Nacional de Justiça

Abstract

This paper discusses the main guidelines for deinstitutionalization/dehospitalization of individuals sentenced to security measures (criminal sentences on the mentally ill) on the criminal system since the publication of Resolution 487, which leads to a reflection about the current practices of the courts and about the guidelines of the Brazilian psychiatric reform (broadly defined and explicitly provided in Law 10.216/01). Our research reveals that the continued use of hospitalization in custody hospitals as the main method of treatment (asylum security measure) retains its punitive nature justified by the “diagnosis” of the supposed dangerousness of the patient. This practice contradicts the widely recognized guidelines of psychology and psychiatry, which state that mental health patients should not remain deprived of social interaction in a long-term hospitalization regime. Our work visits the historical discussion involving the prescription of hospitalization treatment for psychiatric patients as a method of concealing the real intention of isolating and “normalizing” the deviant individuals, ignoring scientific evidence of the effectiveness of this sort of treatment. Another aspect addressed is the discussion about the concept of dangerousness, which is used to justify the type of security measure sentence and their duration. The paper argues that dangerousness is an open pseudoscientific concept still employed in psychiatry. Additionally, the research refers to the well-known conditions of custody hospitals in Brazil and the existing data about the sentences on the mentally ill, pointing out how many people still remain in these institutions under unhealthy and inhumane conditions. Finally, the main subjects of Resolution 487 are presented, showing its purpose and relation to other public policies, as well as indicators of its practical application.