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March 2010
Brazilian Association of Psychiatry Community Program Uses Theater

The "Psychiatry for a Better Life" project, an initiative of the Brazilian Association of Psychiatry (ABP) Community Program aimed at direct contact with the population, has been developed since 2006 in parallel with the activities of the Brazilian Congress of Psychiatry.

In all the previous editions, the project consisted of free talks given by specialists affiliated with the Brazilian Association of Psychiatry but in São Paulo the project had a different format. In addition to the talks and distribution of educational materials, this year the project featured three theater sketches aimed at raising public awareness on the issue of stigma in mental health. With the title "Passing Stigma" (a play on words with subway passengers in Portuguese), the activities approached the most common mental disorders like depression, anxiety and drug addiction.

The project was designed in partnership with the São Paulo Subway Company, which provided both the space for the project and financial sponsorship for the sketches. According to the president of the Brazilian Association of Psychiatry, João Alberto Carvalho, the partnership is an institutional innovation. "ABP Community is an essential program for our institution. That’s why it has been developed over the years with our own funds, with no sponsorship from the pharmaceutical industry. This partnership now marks the beginning of a new moment, with participation and support from the private sector."

Theater
The 15-minute sketch staged in São Paulo subway stations tells a story that discusses stigma and mental health, especially the issue of prejudice against psychiatry. Marcos Creder, a psychiatrist from the State of Pernambuco, wrote the script for "Passing Stigma" and defined the sketch’s light, good-humored approach. As he put it, the plot aimed to call spectators’ attention to the issue. "The notion of claiming that there’s no stigma or prejudice would be highly hypocritical. What we mean to do is demystify the issue" he explained.

The sketches were staged by a local theater group called Satyrus. According to producer Robson Catalunha, the comical approach can facilitate the work. "A great potential trump in any kind of educational work is the funny side. Through laughter, people can have fun and learn, avoiding it from becoming heavy, boring, or dramatic, which would defeat the purpose." According to the artist, people in São Paulo were urged to reflect on mental health. "They watched the sketch for 15 minutes and got information that can help them modify their way of thinking" he concluded.

Sketch Depicts Stigma in Mental Health
During the first presentation of the sketch "Passing Stigma", a woman passerby in her sixties approached one of the organizers of the Psychiatry for a Better Life project, who was watching. She was curious to know what the uproar on the boarding platform was all about.

"Ma’am, can you tell me what’s going on?"
"Sure. They’re putting on a sketch to help people get a better understanding of mental disorders."
"Then I’m leaving. I’m afraid of those things."

This exchange, which lasted less than a minute, illustrates the importance of programs like ABP Community for raising public awareness on issues related to mental health. João Alberto Carvalho, president of the Brazilian Association of Psychiatry, summed it up like this: "We know society has made important strides in its understanding of mental illnesses, which further reinforces the need to expand the perception that mental health is an essential health issue for quality of life."

The Play Itself
On November 3, at 12:30 PM, passengers on the boarding platform at the Itaquera subway station (located in poor area of São Paulo) were surprised by questions from three "scientists of the future" who were trying to discover the name of that psychiatric hospital. After two passengers informed them that they were not really inside some treatment institution but on the boarding platform for public transportation, the "scientists" decided to test the "Stigma Receiver Device", a special piece of equipment that detects scars in the brains of mental patients as those people could not be normal.

The scene sounds absurd. But this was exactly the aim of the text proposed by psychiatrist Marcos Creder and staged by the Satyrus theater group: using the unexpected to call the public’s attention to the sketch and spark reflection on stigma in mental health. After the "test", the passengers that spoke with the "scientists" (who were actually troupe actors) explained to the audience that people who undergo psychiatric treatment should not need to bear stigmas or scars.

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