Mental health care in the Family Health Program:: consensus and dissent in practices and principles under the psychiatric reform and health reform in Brazil

In many psychiatric reforms based on the principles of deinstitutionalization of psychiatric patients and the consolidation of territorial systems for mental health care, the emphasis is on a mental health care system that includes the primary care network. In Brazil, the Psychiatric Reform emerged within the country's overall Health Reform, with which it shares common principles for reorienting the model of care. The current article discusses the links between these two movements through actual mental health care practices within the Family Health Program (FHP), based on an ethnographic study with four family health teams, in which the authors prioritize health workers' narratives. The article analyzes these practices, the discrepancies between guidelines and practice, obstacles and advances in the operationalization of activities, and limits to the comparison and potentialities for crosscutting application of particular epistemological fields like expanded clinical mental health practice and the FHP The discussion is based on such concepts as the psychosocial care model, comprehensive care, social participation, territoriality, and collective actions.