On Saturday, August 31, 1940, President Getulio Vargas visited the Juliano Moreira Psychiatric Colony to inaugurate two new pavilions designed with more than 840 beds for the mentally ill. During his tour of the institution, Vargas conversed with patients and listened to them attentively. The inauguration ceremony was deliberately scripted to celebrate the state, and in particular, Vargas's patronage of the institution. It formally began with a speech by Minister Gustavo Capanema exalting the social assistance program of the Vargas administration, followed by psychiatrist Adauto Junqueria Botelho's generous appraisal of the colony's various therapeutic services that would not have been possible without the Vargas administration. Botelho, a psychiatrist who was a student of Juliano Moreira’s, was the newly appointed director (1941–54) of the National Service for Mental Illnesses. The third and final part of the ceremony consisted of a patient presenting the president with an ornate, hand-carved wooden box on the behalf of all the mentally ill patients. The iconic photograph, used by the major newspapers of the day, captures the passing of the present over a table filled with food and a large flower arrangement. It is arresting not only for what it reveals but also for what it renders enigmatic. Behind the mentally ill man is a woman whose identity is unknown. Behind Vargas, standing conspicuously in front of two Brazilian flags, is a cohort of state officials. The colony's psychiatrists are absent. While the divide between sane-insane, citizen-state, black-white had ostensibly been breached by the mentally ill man and Vargas for a moment, the facilitators of these breakthroughs were ontologically silent. In many ways, this photograph marks the extent to which Brazil had entered a new era. Although still a productive good for the use of both nation and state, at this new juncture psychiatry was to play a supporting role rather than a lead role, giving way to the state to facilitate and manage mental health care more directly.

This book traces the emergence of psychiatry in Rio de Janeiro by focusing on the ways in which psychiatrists created initiatives and programs to address mental illness and to serve the mentally ill.