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ABSTRACT The Hellenic psychiatric reform has constituted the trigger for the de-institutionalization and outpatient treatment of the mentally ill. Until the end of the 20th century, conditions in the inadequate national network of mental health services had been inappropriate. In 1981, the year that Greece joined the European Union, the member-states encouraged Greece to make fundamental changes by modernising the sector of mental health. The purpose would be to create a national reform programme for establishing community psychiatry, closing the country's psychiatric hospitals and deinstitutionalizing long-term mental patients. This project was designed and financed by the European Union and the Greek Ministry of Health. This review focuses on the content and implementation of the Hellenic psychiatric reform and of the national programme "Psychargos". Through the years, the existing structures providing mental health services have been modernised and many new ones have emerged. The Ministry of Health, however, making an account of the planning for years 1984-2009 notes that focus was primarily given to releasing mental patients from psychiatric hospitals rather than developing community structures. Despite the problems that psychiatry reformation has to face, and in spite of the considerable work accomplished, the service network remains in adequate.

This article discusses, temporally, the Brazilian psychiatric reform since its initial formulation to the present time – that is, from the organization of the anti-asylum struggle movement, even under the military dictatorship, until now – a time of neoliberalism marked by an offensive conservatism. It argues about the need to fight conservatism and neoliberalism, as both walk in the opposite direction to the principles of the Unified Health System and psychiatric reform (such as universality, integrality, equity, care in freedom, the non-commodification of madness and the end of asylums). It demonstrates the importance of territorially based services, the work of social workers and multidisciplinary teams in the field of mental health, as opposed to biomedical-psychiatric and hospital-centred. It discusses, therefore, the relationship between mental health and social issue. In addition, this article presents the contributions of Brazilian psychiatric reform, considering the socio-historic context to identify the main advances, challenges and limitations, and to contribute to the consolidation of the reform principles.

The situation of mental health care in Slovenia is briefly reviewed. The reduction of beds in psychiatric hospitals has started already in the 1970s; a further decrease has occurred in the last few years. The number of admissions to these hospitals has increased recently, while hospitalizations have become shorter. On the other hand, the access to psychiatric outpatient facilities is becoming increasingly difficult. Under these circumstances, it is necessary to enhance community mental health care. Patients and families have great expectations about the new mental health legislation, which is supposed to be associated with a national mental health program.

The implementation of the 1978 psychiatric reform in Campania, the most populated region of Southern Italy, is surveyed, by referring to currently available empirical data. Emphasis is laid on the incomplete development of psychiatric wards within general hospitals and of mental health services, on the lack of residential structures, on the failure to implement comprehensive departments for mental health care, on the increase in the number of admissions to private clinics and on the fact that more than three thousand patients are still in mental hospitals. Moreover, some characteristics of the new services clearly betraying the spirit of the law are pointed out.

Intro -- Foreword to the International Edition, by Manuel Desviat Brazil (1976-2016) - Four Decades at the Forefront of Psychosocial Care for Psychic Suffering -- References -- Foreword to the Brazilian Edition -- Author's Preface to the International Edition -- Acknowledgments -- Contents -- Chapter 1: Introduction: Dimensions of the Psychiatric Reform as a Complex Social Process -- 1.1 Theoretical-Conceptual or Epistemological Dimension -- 1.2 Technical-Assistance Dimension -- 1.3 Legal-Political Dimension -- 1.4 Sociocultural Dimension: Producing a New Social Place for Madness and Psychological Suffering -- References -- Chapter 2: The "Industry of Madness" Is Denounced: Birth of the Brazilian Psychiatric Reform -- 2.1 The 1980s: From Institutional Criticism to the "Institutionalization" of the Psychiatric Reform -- 2.2 Late 1980s: From Institutional Critique to De-institutionalizing Practices -- 2.2.1 Center for Psychosocial Care -- 2.2.2 Innovative Experience of the Santos Substitutive Network -- 2.2.3 The NAPS Project Within the Framework of the Santos Proposal -- 2.3 The End of the 1980s: The Psychiatric Reform Bill -- 2.3.1 The Network of Comprehensive Mental Health Care as a Substitute for Mental Institutions in São Paulo -- 2.4 The 1990s: Caracas Declaration and Psychiatric Reform in the Latin American Region -- 2.5 Expansion of the Notion and Meaning of Networks and Psychosocial Care Services -- 2.6 The 2000s Onward: Advances, Innovations, and Problems During Psychiatric Reform -- 2.6.1 A New Political Framework: RAPS -- 2.6.2 Mental Health in Primary Care: Radical De-institutionalization? -- References -- Chapter 3: The Sociocultural Dimension: Concrete Experiences About Production of a New Social Place for Madness and Psychological Suffering.

Abstract
This study examines the initial impact of a broadly participatory planning process in the Czech Republic during 2016–2017, aimed at both reducing inpatient care and expanding community mental health systems, on policy and programmatic decision making. A central focus of the study involves the trade-offs between and efforts to integrate shared decision making with evidence-based planning methods within the context of a national psychiatric reform strategy, particularly one involving a former Soviet bloc state.
Given the uniqueness of the Czech experience, an exploratory case study methodology is used, one involving ten interviews with key informants and examination of a wide variety of documents. Results include the development of broad new decision and oversight structures, and the initial implementation of community mental health services. The nation faces some of the same trade-offs found elsewhere, such as in the United States, between an inclusive participatory process, and one that systematically incorporates empirical rational and evidence and best practices within bounded parameters.
Implications for new psychiatric deinstitutionalization initiatives are identified, including development of a national mental health authority, a professional workforce, new funding strategies, multi-level service coordination, mechanisms to assure transparency, among others.

RESUMO O propósito do artigo foi visibilizar o processo de constituição e implantação do Fórum Permanente de Centros de Convivência e Cultura (Ceco) no estado do Rio de Janeiro. Descreveram-se as etapas de sua gênese, os pressupostos teóricos de sua formulação e os desdobramentos legais, éticos e políticos dos dispositivos de convivência no âmbito da Reforma Psiquiátrica Brasileira. A experiência do Fórum forneceu três pistas metodológicas que podem ser úteis para a construção de políticas: 1) abertura, estar aberto à participação de todos, não restringir; 2) itinerância, movimentar-se sem se fixar em um mesmo lugar; 3) multiplicidade, desejar as diferenças e não obstruir o trânsito entre elas. Como produto desse movimento instituinte, foi gerado coletivamente o Projeto de Lei nº 4.563/2018, que cria a Política Estadual dos Centros de Convivência da Rede de Atenção Psicossocial no estado do Rio de Janeiro, apresentado pela frente parlamentar em defesa da saúde mental e luta antimanicomial na Assembleia Legislativa do Estado do Rio de Janeiro. O movimento em torno dos Ceco, dispositivos de promoção de encontros na cidade, sustenta-se a partir da produção do comum e busca dar sustentabilidade à política da convivência que resiste às tentativas de desmonte do SUS e ao neoliberalismo.

Professionals practising psychiatry in the US and the UK have reacted to the Italian psychiatric reform in a number of ways. This paper sets out to explore these responses in the light of the significance of the reform and its implications for these professionals.

Objective: investigating the contributions of national scientific researches on family knowledge about mental health services after the Brazilian psychiatric reform. Method: this is an Integrative Literature Review with simultaneous use of the descriptors "mental health" and "family", in the LILACS database, in the period from 2001 to 2013, selected 24 scientific articles. Results: the emerging themes were: "services capabilities in the context of the Brazilian Psychiatric Reform", "family participation" and "weaknesses faced in the execution of Brazilian Psychiatric Reform". Conclusion: families recognize the importance of substitute services in assisting their family member with mental disorder. On one side, we highlight several structural, organizational and political weaknesses of these services. The other, identify some successful strategies in Brazil, which demonstrated that the barriers found for the effectiveness of psychiatric reform can be overcome.

This work aimed to characterize the mental health care network in a small city in the state of Paraná. This is a qualitative and exploratory research, which used the semi-structured interview as data collection technique. The group of the research subjects consisted of a municipal Health Department management representative and workers linked to primary, ambulatory and hospital care. From the data obtained, we dealt with some of the challenges that arise in the path of care models construction consistent with the guidelines of psychosocial care. We were able to observe that instead of a network, there are some care centers in the city, which do not always present themselves articulately. The care was focused on the binominal ambulatory-hospital and the assistance offered had a markedly medicinal character, grounded in biomedical perspective. We noticed the existence of a doctor-centered model to the detriment of a user-centered practice. This way, we point to a mismatch on the Reform trajectory in the Brazilian scenario, because if on the one hand there were a lot of advances in some cities and states, in others places the Reform does not seem to have a significant impact towards the consolidation of a new care model.