The reorganization of mental health care in Brazil promoted by the Movement for Psychiatric Reform goes beyond the offer of new services and the reorganization of models of care. It concerns deep changes in social response to madness and implies changes in political, ideological, and ethical issues as well as in clinical and rehabilitation concepts. In this article we identify impasses related to the absorption of the Movement for Psychiatric Reform by federal and state government policies. We also approach issues resulting from such policies as they are put into practice in the services rendered. Finally, we discuss the strategic role of the management of these services in the application of the governments’ general guidelines for quality care.
Health care evaluation; health care management; health policies; psychiatric reform