Beginning in the 1980s, the process of shifting from hospital to community-based care in Brazil has been recognized as an exemplary experience. The main objective of the Brazilian psychiatric reform has been the extension of citizenship rights to people with mental problems, especially those forced to undergo extensive confinements in psychiatric hospitals. Deinstitutionalization has been a major goal of this process, understood not only as the removal of users from hospitals, but also as the creation of effective conditions for continuous and qualified community care for all those in need of attention and treatment. The Brazilian reform process is still undergoing substantial advances, and the purpose of this seminar was to discuss its innovations and challenges.

The discussion was based on two working documents. On the one hand, the document "Innovation in deinstitutionalization: a WHO expert survey", co-produced by the World Health Organization and the Gulbenlkian Global Mental Health Platform, and, on the other hand, the Technical Document "Innovations and Challenges in Deinstitutionalization and Community Care in Brazil", written for this Seminar. Based on these documents and after three days of open discussion, the participants at the seminar agreed on several recommendations about the barriers and effective strategies of deinstitutionalization and community care in Brazil.