Political Activism and Advocacy in Mental Health

Advocacy Intersectionality Prevention and Promotion Public Policy

Making structural and systemic changes to the way we deal with mental health in Brazil depends on how public policies are designed, implemented and evaluated. That’s why the Cactus Institute works to expand and define the debate on the subject with representatives of the public authorities, the press and other organizations of civil society. 

Our efforts at political activism and advocacy aim to advance the agenda of preventing illness and promoting mental health through two types of action: top-down and bottom-up. 

For top-down, we offer technical support for the formulation, implementation and evaluation of public mental health policies. To do this, we accompany and seek engagement with representatives of the national executive and legislative branches. We provide technical support to legislators for drafting bills, participate in public hearings in Congress, keep the population informed via the press, mobilize players of civil society to become involved in the issue, provide data and evidence for public policy makers and monitor the status of mental health policies and equipment.  

A practical example of this type of action was the agenda program for the 2022 elections. In partnership with the Institute for Health Policy Studies (IEPS) and the political consulting firm Eixo Estratégia, the Cactus Institute developed an agenda with specific mental health commitments to help presidential candidates formulate their platforms. Comprising recommendations from health experts and managers, based on a broad diagnosis of the country’s health conditions and outcomes, the agenda was delivered to the presidential candidates.

The Cactus Institute is also one of the creators, backers and members of the Board of the Mixed Parliamentary Front for the Promotion of Mental Health, which mobilizes congressmen and senators to advance this agenda in Congress. 

The bottom-up method focuses on public mental health policies that are already being delivered to the population and the daily challenges that exist in implementing and managing these policies. We offer projects and tools to municipal and state governments and managers to help manage SUS mental health facilities.  By creating local data and indicators for local managers, or even composite mental health indices, we help these managers identify the status of social determinants for mental health in their regions. 

Alongside these two areas of advocacy and policy, we use our communications to mobilize and raise awareness among civil society and public policymakers about the need for progress in the field of prevention or illness and promotion of mental health. We not only seek to inform, but also to educate all these actors.


  • Broadening public understanding of mental health policies and their importance, with a focus on reducing the stigma associated with mental health. 
  • Influence on legislative and executive agendas and on the formulation of public mental health policies, by qualifying bills and participating in public hearings. 
  • Dialogue between government institutions and non-governmental organizations on the issue, fostering collaboration in the mental health ecosystem. 
  • Construction and participation, as an Advisory Board and backer, of a Parliamentary Front specifically focused on the theme of promoting mental health.
  • Co-creation of a mental health focus in the “More SUS Agenda” for the 2022 presidential elections;
  • Production of documents that inform public policy makers and society about ways to move forward in preventing illness and promoting Mental Health, with emphasis on:
  • The status of National Mental Health Policies and Programs;
  • Mental Health Diagnosis – More SUS in Evidence; and
  • A primer with recommendations for public mental health policies in schools. 
  • Technical collaboration for drafting and passing Bill of Law (PL) No. 3.383/2021, which establishes the National Policy for Psychosocial Care in School Communities, the “Mental Health in Schools Bill.” 

Lessons for the ecosystem

  • Working on PHC is key: PHC, which is known as the “gateway” to the health system, is fundamental for working on human suffering in a fuller way, but there are important challenges to support matrices and integration between networks.
  • Epidemiology and resistance to disasters: There is a gap in mental health work in disaster and pandemic situations.
  • Need for adaptability in advocacy work: The election period also has a general impact on activities in the National Congress and the prioritization of actions and activities in the Executive.
  • Importance of Mental Health: we need to work on the importance and urgency of mental health as a multifaceted issue in politics, and civil society has a privileged role to play in defining the debate with data and evidence.
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