![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/07\/jorge-vaz-hospital-barbacena-800x600.jpg\")
A security checkpoint at the entrance to Jorge Vaz Forensic Psychiatric Hospital in Barbacena. (Mar\u00edlia Marasciulo\/Courthouse News)<\/p>\nBARBACENA, Brazil (CN) \u2014 Twenty-five years after Brazil adopted a landmark psychiatric reform law, a 21-year-old man accused of stabbing his mother to death has spent weeks in a jail waiting for a bed in the kind of institution the country\u2019s judiciary is now seeking to close.<\/p>\n
Arrested May 23 and held in Barbacena, he became the first case in the city of about 130,000 people in the southeastern state of Minas Gerais to test how local authorities would implement a national policy replacing forensic psychiatric hospitals with treatment through the public health system.<\/p>\n
In Brazil, people with mental illness are not usually identified to protect their privacy.<\/p>\n
A court opened a mental competency proceeding June 2 to assess whether he can be held criminally responsible. Prosecutors requested his temporary hospitalization, but the transfer depends on the Minas Gerais Justice and Public Security Department making a bed available. A psychosocial evaluation is scheduled for Friday.<\/p>\n
He remains jailed while a judicial program for people with mental illness in the criminal justice system coordinates his care with Barbacena\u2019s health services.<\/p>\n
A security checkpoint at the entrance to Jorge Vaz Forensic Psychiatric Hospital in Barbacena. (Mar\u00edlia Marasciulo\/Courthouse News)<\/p>\n
The case exposes a national impasse over National Council of Justice Resolution 487<\/a>, adopted in 2023, which ordered the gradual closure of forensic psychiatric hospitals. It also requires people with mental illness who enter the criminal justice system to receive treatment through the public health system rather than in institutions that function as both prisons and psychiatric hospitals.<\/p>\n Brazil\u2019s Psychosocial Care Network includes primary care facilities, community mental health centers, therapeutic residences, community centers and mental health beds in general hospitals.<\/p>\n The policy is grounded in 2001\u2019s Law 10,216<\/a>, which redirected mental health treatment and prohibited hospitalization in asylum-like institutions.<\/p>\n Resolution 487 also requires periodic reviews of court-ordered treatment and individualized care plans. Hospitalization should be based only on clinical need, last for the shortest possible period and preferably take place in general hospitals.<\/p>\n Four challenges to the resolution remain pending before Brazil\u2019s Supreme Court. Justice Fl\u00e1vio Dino requested additional time to review the cases in July 2025 and returned them for judgment in November. The court\u2019s press office said there is no date for proceedings to resume.<\/p>\n The young man\u2019s arrival in the system has shown the procedures envisioned by the resolution have not been defined in Barbacena.<\/p>\n Gustavo Ferreira de Souza, Barbacena\u2019s health secretary, said community mental health centers lack specialized teams to evaluate people accused of crimes who may be experiencing psychiatric crises.<\/p>\n \u201cHow is this going to work? What is the procedure?\u201d Souza said. \u201cI don\u2019t have a ready answer because this discussion began now, with this first case.\u201d<\/p>\n The legacy of Hospital Col\u00f4nia<\/p>\n The uncertainty is unfolding in a city that has occupied a central place in the history of Brazilian psychiatric care for more than a century.<\/p>\n Barbacena Psychiatric Hospital Center still bears traces of its past as Hospital Col\u00f4nia, where thousands of people were separated from their families and society. A study based on admission records counted 91,911 patients between 1903 and 1979.<\/p>\n On May 25, 14 remaining residents were transferred to a city-managed facility, marking the definitive end of its asylum model. Their departure completed a deinstitutionalization process that began decades earlier.<\/p>\n Within the hospital complex \u2014 which now operates as a general hospital, research center and teaching hospital \u2014 the Museum of Madness exhibits blue uniforms once worn by Col\u00f4nia patients, electroshock equipment, large kitchen pots and documents related to the sale of corpses.<\/p>\n Another exhibit features a letter from a former state health secretary recommending the adoption of a \u201csingle-bed system.\u201d The response to overcrowding consisted of removing beds and replacing them with grass spread across the floor, where patients slept without clothing even during Barbacena\u2019s winter, when average temperatures are close to 55 degrees Fahrenheit.<\/p>\n In 1979, Italian psychiatrist Franco Basaglia, whose work led to the closure of psychiatric institutions in Italy, visited the Col\u00f4nia and compared it to a concentration camp. News reports, books and documentaries later turned Barbacena into a national symbol of psychiatric abuse.<\/p>\n Cidinha Umbelino began working at the hospital at 18 and will complete 47 years there in August. The nurse said the abuses and overcrowding cannot be separated from government neglect and the conditions faced by workers.<\/p>\n \u201cThis was created to be a place that cared for mental health, and it ended up overcrowded,\u201d Umbelino said. \u201cNobody talks about how this happened because of neglect and the government\u2019s failure to take responsibility. They say it was our fault. It wasn\u2019t.\u201d<\/p>\n Umbelino acknowledged that care was poor at times, but said too few employees were responsible for hundreds of patients.<\/p>\n \u201cI worked in a unit with 600 people, and there were three of us,\u201d she said. \u201cIt is time for someone to report that this hospital did not only mistreat people, kill people and sell bodies. Since psychiatric reform began, we were always guiding this place toward where it eventually arrived.\u201d<\/p>\n Waldir Damasceno, 73, coordinator of Barbacena\u2019s municipal museum, has lived in the city since he was 7 and helped establish the first version of the Museum of Madness. At the time of its creation, some residents feared the museum would reinforce Barbacena\u2019s stigma as Brazil\u2019s \u201ccity of the mad.\u201d<\/p>\n He said the label had become inseparable from the city\u2019s history.<\/p>\n \u201cI am not ashamed,\u201d Damasceno said. Preserving that history, he said, is necessary to prevent such abuses from happening again.<\/p>\n On June 3, Dino granted an injunction<\/a> requested by Minas Gerais prosecutors, allowing new admissions at the Jorge Vaz Forensic Psychiatric Hospital in Barbacena and the Medical and Forensic Support Center in Ribeir\u00e3o das Neves. Dino limited his ruling to the two hospitals and did not suspend the resolution elsewhere in the state.<\/p>\n The Minas Gerais Justice and Public Security Department denied Courthouse News access to the Jorge Vaz hospital, citing security concerns. The department declined a full interview but said it continues to comply with court orders governing the treatment of people in custody who need mental healthcare.<\/p>\n The closure of the Col\u00f4nia and the continued operation of the Jorge Vaz hospital place two stages of Brazil\u2019s psychiatric reform side by side.<\/p>\n Fl\u00e1via Vasques, Barbacena\u2019s mental health coordinator, said closing the Col\u00f4nia did not mean the city had completely broken with the institutional culture built over more than a century.<\/p>\n \u201cBarbacena is still permeated by asylum logic,\u201d Vasques said. \u201cEven the forensic psychiatric hospital here was a response to this entire hospital environment that existed in the city.\u201d<\/p>\n Nestor Santiago, a criminal defense lawyer and professor at the University of Fortaleza and the Federal University of Cear\u00e1, said closing forensic psychiatric hospitals does not mean releasing or abandoning people under court-ordered treatment.<\/p>\n \u201cWhen the state\u2019s power to punish is combined with medicine\u2019s power to confine, without oversight or a commitment to freedom, the result is barbarism,\u201d Santiago said. \u201cThe judiciary\u2019s current anti-asylum policy is a belated attempt to ensure that the justice system is never again complicit in abuses like those committed in Barbacena.\u201d<\/p>\n Andr\u00e9a Brito, an auxiliary judge at the National Council of Justice, said there is a historical continuity between the old psychiatric colonies and forensic psychiatric hospitals. Psychiatric reform reduced long-term institutionalization and replaced isolation with community-based care, she said, but largely left the forensic system behind.<\/p>\n \u201cThe judiciary\u2019s anti-asylum policy seeks precisely to complete this historical process by extending deinstitutionalization to people with mental illness who are in conflict with the law,\u201d Brito said.<\/p>\n The case of Dami\u00e3o Ximenes Lopes also helped shape the judiciary\u2019s approach. On July 4, 2006, the Inter-American Court of Human Rights held Brazil responsible<\/a> for failures in the investigation and judicial response in Ximenes Lopes\u2019 1999 death, which occurred three days after he was admitted to a psychiatric clinic in the northeastern state of Cear\u00e1.<\/p>\n It was the court\u2019s first ruling against Brazil and its first decision involving the rights of people with mental illness.<\/p>\n \u201cWe are internalizing the standards of the Inter-American system by incorporating into the judiciary the principles of psychiatric reform, the Convention on the Rights of Persons with Disabilities and the case law of the Inter-American Court itself,\u201d Brito said.<\/p>\n Brito said 10 states have closed their forensic psychiatric hospitals or equivalent institutions since Resolution 487 was adopted, and the number of teams connecting courts with the public mental health network has risen from five to 37, now operating in 25 of Brazil\u2019s 27 federal jurisdictions.<\/p>\n About 1,200 people were hospitalized in forensic institutions during the second half of 2025, Brito said \u2014 half the 2023 peak of about 2,400.<\/p>\n But some groups \u2014 like the Brazilian Psychiatric Association<\/a>, the National Association of Members of the Public Prosecutor\u2019s Office<\/a> and the center-right parties Podemos<\/a> and Uni\u00e3o Brasil<\/a> \u2014 argue that the National Council of Justice changed criminal law without congressional approval.<\/p>\n Ant\u00f4nio Geraldo da Silva, president of the Brazilian Psychiatric Association, called the resolution a setback in the care of people subject to court-ordered treatment.<\/p>\n \u201cBy proposing the replacement of specialized hospitals without an effectively prepared network to absorb these patients, the rule creates a real risk of lack of care, interruption of treatment and worsening clinical conditions,\u201d Silva said.<\/p>\n Silva said Brazil\u2019s 2001 psychiatric reform law does not require the closure of psychiatric or forensic hospitals and recognizes hospitalization as a treatment when medically indicated.<\/p>\n \u201cIt is a mistake to imagine that a single model of care can serve every patient,\u201d Silva said.<\/p>\n Minas Gerais officials have raised similar concerns. During proceedings over Dino\u2019s injunction, Paulo de Tarso Morais Filho, head of the state prosecutors\u2019 office, said about 95% of the state\u2019s municipalities lack the services needed to absorb forensic patients.<\/p>\n Brito said states claiming that their health networks are unprepared should provide data on available services, geographic distribution, coverage and the number of people requiring care.<\/p>\n She acknowledged persistent obstacles, including stigma and the risk of patients being moved to regular prisons or asylum-like institutions, but said state experiences show deinstitutionalization is possible.<\/p>\n F\u00e1bio Baccheretti, Minas Gerais\u2019 health secretary, said forensic hospitals should be replaced but defended a slower transition.<\/p>\n Minas Gerais is expanding community mental health centers, therapeutic residences and primary care coverage. The state spends about 100 million reais ($20 million) a year on community mental health centers, Baccheretti said.<\/p>\n He warned that in some states, closing forensic hospitals merely transferred patients to conventional psychiatric hospitals that then became permanent housing.<\/p>\n \u201cA hospital is not the best place to live,\u201d Baccheretti said. \u201cThe best place to live is a home.\u201d<\/p>\n Courthouse News reporter Mar\u00edlia Marasciulo is based in Brazil.<\/p>\n Subscribe to our free newsletters<\/p>\n Our weekly newsletter Closing Arguments offers the latest about ongoing![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/07\/antonio-carlos-pavillion-barbacena-800x600.jpg\")
The Ant\u00f4nio Carlos Pavilion at the Barbacena Psychiatric Hospital Center, historically known as Hospital Col\u00f4nia. (Mar\u00edlia Marasciulo\/Courthouse News)<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/07\/hospital-colonia-barbacena-800x600.jpg\")
A historical photograph of a crowded ward at the Barbacena Psychiatric Hospital Center, displayed at the Museum of Madness. (Mar\u00edlia Marasciulo\/Courthouse News)<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/07\/leito-unico-800x600.jpg\")
A letter from a former Minas Gerais health secretary recommending a \u201csingle-bed system\u201d is displayed at the Museum of Madness in Barbacena. The policy removed beds and replaced them with grass spread across the floor, where patients slept. (Mar\u00edlia Marasciulo\/Courthouse News)<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/07\/waldir-damasceno-barbacema-800x600.jpg\")
Waldir Damasceno, coordinator of Barbacena\u2019s Municipal Museum, sits inside the museum in Barbacena, Minas Gerais. (Mar\u00edlia Marasciulo\/Courthouse News)Judicial and historical continuity<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/07\/electroshock-equipment-barbacena-800x600.jpg\")
Electroshock equipment and historical photographs displayed at the Museum of Madness in Barbacena. (Mar\u00edlia Marasciulo\/Courthouse News)<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/07\/hospital-colonia-closure-memorial-barbacena-800x600.jpg\")
A plaque marks the permanent closure of the Barbacena Psychiatric Hospital Center on May 25, 2026. (Mar\u00edlia Marasciulo\/Courthouse News)<\/p>\n![](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/07\/museum-of-madness-barbacena-800x600.jpg\")
The Museum of Madness occupies one of the original buildings of the former Barbacena Psychiatric Hospital Center, historically known as Hospital Col\u00f4nia and now called the Barbacena Hospital Center. (Mar\u00edlia Marasciulo\/Courthouse News)<\/p>\n
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