A Faith-Based Mental Health and Development
Project for Slum Dwellers in Brazil Sidney M. Greenfield University of
Wisconsin-Milwaukee Abstract
This paper describes a combined mental health and
development program being carried out under the direction of a Comboni
Missionary who is an ordained Roman Catholic priest from Italy who also is a
medical doctor presently completing a Ph.D. in psychiatry in Brazil. It is based
on a theoretical framework that integrates the cultural and religious
backgrounds of migrants coming into the slums of Brazilian cities with a form of
group therapy based on the assumptions of Liberation Theology that was developed
by Prof. Adalberto Barreto, a practicing Brazilian trained MD-psychiatrist with
European Ph.Ds in psychiatry and anthropology. We show that this unusual
combination of anthropological insight combined with a unique approach to group
psychotherapy, rooted in a humanistic approach to religion, has resulted in an
extremely effective development program that is beginning to be applied in slum
areas in other parts of Brazil and elsewhere..........*
See attachment, included with the E-mail link sent about this
program, for a Full Text document
of Father Bonvini's Work. H.H.C.
FORTALEZA, Brazil,
Aug 9, 2009 (IPS) - Zilá
Ferreira and Juraci
Lisboa were in the grip
of depression since 1996
– the former over the
death of her mother, and
the latter because she
was "abandoned with
seven children under
14."
Both of these Brazilian
women, who were 36 years
old at the time, began
staying in bed for days
on end, unable to muster
the motivation to get
up.
"Life wasn't worth it
anymore; all I did was
cry, and I was afraid of
everything," says
Ferreira. Nevertheless,
she refused to take
psychiatric medication,
protesting that "I'm not
crazy."
"I didn't think I would
be able to raise my
kids; I had never worked
outside the home," says
Lisboa.
Help came from "Father
Rino", who had just
launched the Community
Mental Health Movement
in Bom Jardim, one of
the poorest, most
violent neighbourhoods
in Fortaleza, the
capital of the
northeastern Brazilian
state of Ceará, where
Ferreira and Lisboa have
lived since their
families left the
countryside three or
four decades ago.
"Father Rino gave me
such a warm hug" and
"life once again had
meaning," says Ferreira,
describing how she found
support in the Movement,
where she received
training as a massage
therapist and has worked
since 1998.
In the case of Lisboa,
she is so happy today in
her job as a cook that
she would prefer not to
have days off or
vacation. Overcoming
depression, she says,
was a lengthy process,
with "ins and outs, like
the tide," until she
finally came to realise
that "I wasn't left by
my husband; I was
liberated.
"I put up with his
alcoholism and his
humiliation of me for
years, because I thought
that was my duty as a
wife," she says.
Today she regrets that
her father did not allow
her to go to school
beyond fourth grade.
Ferreira had even worse
luck in that sense. "I
was illiterate, I had no
opportunity to study as
a girl." When she
decided to take adult
literacy classes, her
husband literally locked
her in the house. He
would not even let her
talk to the neighbours,
she says.
Alcoholism is a major
problem in Bom Jardim,
affecting a full 45
percent of families,
followed by depression,
which affects 4.5
percent of families,
according to Father Rino
- Ottorino Bonvini - a
Comboni priest and
psychiatrist from Italy
who chose Fortaleza for
his community mental
health mission.
In 1993, when he learned
in a congress of
psychiatrists about a
"community therapy"
method developed by his
Brazilian colleague
Adalberto Barreto, a
professor at the Federal
University of Ceará, he
felt he had found what
he was looking for: a
way to promote mental
health in society as a
whole, including the
poor.
He was drawn to Latin
America because of
Liberation Theology, a
progressive current in
the Catholic Church that
declares a "preferential
option for the poor" and
fights for social
justice.
And he chose Bom Jardim,
a neighbourhood of
around 200,000 people on
the outskirts of
Fortaleza, because the
Comboni Missionaries are
active here.
In 1996, he began to
train dozens of
community therapists and
launched the Community
Mental Health Movement,
which now operates in 10
centres around the
neighbourhood and
surrounding areas.
"Community therapy is
only the gateway" to the
Movement, Father Rino
told IPS. It is
practiced among groups
of people sitting in a
circle, who try to help
each other. Some talk
about their problems,
and they all discuss
cases chosen as
examples, sharing their
experiences and
solutions.
In many cases, the group
therapy and the bonds of
solidarity and support
built up at the weekly
meetings are sufficient
to enable the
participants to overcome
their problems.
The idea is to drawn on
the community's own
resources, culture, and
accumulated knowledge
and experience to
collectively strengthen
mental health, says
Barreto, the
psychiatrist and
anthropologist who
created the Movement for
the Integration of
Community Mental Health
in 1986, which trains
community leaders in
Brazil's shantytowns.
Barreto's programme got
underway in Pirambú, a "favela"
or shantytown of
Fortaleza that is home
to more than 250,000
people.
The effectiveness of the
innovative community
therapy method has been
widely recognised, and
it has been incorporated
in the public health
system in many Brazilian
cities and replicated in
other countries.
Besides promoting mental
health in poor
communities without
access to individual
therapy options, the
technique acts as a
"filter" for identifying
and referring patients
to the specific
appropriate treatment,
in the few cases that it
is necessary. This
shortens the lines in
public hospitals, which
are thus better able to
provide personalised
care to those who really
need it.
The Movement now forms
part of a policy
established by law in
2001, aimed at avoiding
the hospitalisation of
mental health patients,
and encouraging their
return to the home and
the community, as well
as social participation
in prevention of mental
health problems and
assistance for
sufferers.
Psychosocial Care
Centres, created by that
policy, are mushrooming
around the country. They
now number around 1,600
nationwide, and in
Fortaleza they have
grown from three in 2005
to 14 today.
The Bom Jardim
Psychosocial Care
Centre, which opened in
2005, is run by the
Movement under an
agreement with the city
government, and has
"important synergy" with
the Movement, according
to Father Rino.
The Movement offers its
experience in community
therapy and other mental
health activities, as
well as in efforts to
fight poverty, while the
agreement with the city
government represents
half of the budget, said
the Centre's financial
administrator, Reni
Dino. Other sources of
funding are social and
cultural projects run by
the state and national
governments, donations,
and sales of the
project's own products.
The expenses of the
Centre, which has 43
employees, range between
30,000 and 40,000
dollars a month – a
small budget explained
by the low salaries paid
and by the fact that
around 120 volunteers
work there, says Dino.
The impact of the
Movement can be gauged
by the reduction in the
number of psychiatric
visits to the Centre,
which have dropped from
3,500 to 1,300 a month,
reflecting major savings
for the public health
system, Dino
underscores.
By means of community
therapy, the Centre
diagnoses mental health
problems like
schizophrenia, psychosis
and clinical depression,
and provides
multidisciplinary
treatment, ranging from
individual psychiatric
treatment to
occupational or arts
therapy, says the
project's educational
coordinator, Ana Claudia
Rodrigues.
The methods used – "biodanza"
(combining music,
movement, emotion and
expression), the arts,
family support,
promotion of self-esteem
and a "green" pharmacy
based on plants with
medicinal properties –
make the therapy more
collective and
innovative and reduce
reliance on drug-centred
treatment.
Aloisio Caminha, 33,
used to require
psychiatric care. Since
he was a boy, he has
suffered from
obsessive-compulsive
disorder and has been
plagued by "persistent
unwanted thoughts,"
expressed as blasphemy
and swearwords that
conflict with his strong
religious beliefs. When
his problems got worse
during his years of
adolescence, he had to
drop out of high school.
The improvement he has
experienced since
receiving help from
Father Rino and
participating in the
Movement's activities,
like self-esteem groups
and computer courses,
explain why he has made
the 1.5-hour journey to
Bom Jardim, involving
three bus transfers,
from his home for the
last three years.
To "pay back" these
benefits, Caminha
volunteers in several of
the Movement's projects,
and hopes to overcome
his problems in order to
study philosophy and
ultimately become a
Franciscan priest.
In the Centre, all of
the employees do a
little of everything.
Financial administrator
Dino, for example, is
also a "biodanza
facilitator."
And Marcio Firmiano, 29,
is not only a fundraiser
but an actor in the arts
and music programme,
which offers local
residents courses in
music, visual arts,
craftsmaking and
theatre.
The programme formed the
group Semearte, which
uses street theatre
techniques. Half of the
income earned from the
shows is funneled back
into the Movement.
It was through this
programme that Firmiano
discovered his vocation
as a clown, with a
character named "Fuxico"
(gossip) who never fails
to leave the audience in
stitches.
But above all, the
Movement is marked by a
"sense of equality" in
the way everyone treats
each other, say Ferreira
and Lisboa, who see
Father Rino not as a
saint or a boss, but
just as "a friend."
(END)
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