CNJ resolution will release killers with mental disorders, says ABP

The president of the Brazilian Association of Psychiatrists (ABP), Antônio Geraldo da Silva, has warned about the dangers to society of the resolution of the National Council of Justice (CNJ) that determines the closure of judicial asylums until May 2024.

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The decision, which takes effect on May 15, will gradually release people with mental disorders who have committed crimes and were being held in psychiatric hospitals by the judicial system. The solution proposed by the CNJ is that these patients, considered unimputable by Brazilian legislation, have home care and start to seek, on a voluntary basis, the Psychosocial Care Network (RAPS) or general hospitals.

In an exclusive interview with People’s Gazette, the psychiatrist points out the risks to public safety and to the patients themselves, noting that some of them have committed serious crimes, such as murder and child abuse. “They are proposing to release criminals, after an expert says that these people are unable to live in freedom”, he laments.

For the psychiatrist, another worrying factor is the difficulty in monitoring these people who will be released and the lack of psychiatric beds in common hospitals and in Raps. “If that person is left to their own devices, how will they have a condition that can be treated properly? She will not have access to the best treatment. She will be in a situation of neglect ”, he points out.

See the full interview:

What should be the effects of the CNJ resolution that determines the end of judicial asylums?

Antonio Geraldo da Silva: The resolution ends, between May 15, 2023 and May 15, 2024, with all custodial and psychiatric hospitals in the country. These people would follow up, if they wanted, in the Raps system. If you need to admit, they will use the available beds. Today, this works differently: in order to define that a person needs to be in a custody hospital, the patient goes through a system of expertise, where the need for custody is attested. With this CNJ decision, what is being done is, via resolution, ending the psychiatric evaluation.

But every time this happened, we had very serious situations, in which people were released without being able to live with society. In the Federal District, for example, there was a case of the release of a pedophile. In the psychiatric report it was written that the person was unable to live in society. They released him and he killed 7 people, teenagers and children. In the prison system, he has no contact with children. How can they say he has good behavior? He doesn’t live with a child when he’s in prison.

Also, there are two types of people involved, [quando se fala de hospitais de custódia]. Mentally ill people who committed crimes and people who became mentally ill by committing crimes. But if that person is left to their own devices, how will they be able to be treated properly? That person will not have access to the best treatment. He will be in a situation of neglect.

Are general hospitals and Raps prepared to care for patients discharged from forensic asylums?

Antonio Geraldo da Silva: The Raps (Psychosocial Care Network) is already a flawed network. Today, in Brazil, we have more than 5 thousand cities and there are not even 2 thousand services. We are unable to care for the 70 million people with a mental problem. And they will also bring this specific group to be treated in this service. It is disrespectful to ordinary patients who are undergoing treatment to mix these dangerous people together.

What is the profile of patients in forensic asylums?

Antonio Geraldo da Silva: Inmates under security measures who need psychiatric treatment and follow-up. The types of crimes are many, for example, are murderers and pedophiles. They are punished and the penalty is not small. But all will be released. Currently, there are 5,800 criminals, according to the Prison System Report in Numbers, by the National Council of Public Prosecutors, who will be released.

Also, several people who will claim mental illness in order to be released.

Was the ABP present on the CNJ working group? Have you done anything to try to reverse the decision of the CNJ?

Antonio Geraldo da Silva: No doctors were invited. There were several guests, less doctors and people who work in the prison system. We asked for a public hearing by the CNJ and we were denied, saying that we should participate in a meeting that will take place in June, in Curitiba (PR). We asked for a hearing and received a denial. And we will participate in this meeting as listeners.

This kind of situation is absurd. Who defines what is disease or not? The psychiatrist. But no doctor participated in the CNJ working group. It was a disdain for the profession.

What would be the best form of treatment for patients with mental disorders who have committed crimes?

Antonio Geraldo da Silva: It’s easier to finish than to build something of quality. It is necessary to have a system to serve this population, but with quality. Bad place, I don’t want it for anyone. Hospitals do not provide adequate care for these people. Quality improvement must be as a whole. Appropriate professionals are needed to care for these patients.

The anti-asylum policy has grown a lot in recent years, also due to the abuse and unpreparedness of asylums. However, what are the consequences of this policy in society?

Antonio Geraldo da Silva: They take away human rights by denying adequate treatment to the sick. They take away the freedom of people who are outside prisons, because they will deal with all kinds of criminals who should be in a custody hospital, but, [devido à resolução do CNJ], will be in everyday life. It’s a mess when you do that. They are putting people’s lives at risk and denying the facts.

They are proposing to release criminals, after an expert says that this person is in no condition to live in freedom. They are disrespecting and exposing the whole society.