Your Editorial on psychiatric disorders (Nature 463, 9; 2010) mentions the misplaced stigma often associated with them. In Brazil, there is strong opposition within certain social sectors to the idea of mental-health interventions. A proposed law to dismantle all psychiatric hospitals in the country has been arousing fierce debate since 2001.

One side argues that the law would end the widespread abandoning of the poor in psychiatric institutions, a practice that has been criticized as detrimental to the patients' chances of long-term recovery. Opponents, however, say that it would eliminate the opportunity for immediate care of acutely affected patients, such as those with suicidal depression or delusional schizophrenia; this would increase the risks for both patients and their families, while placing all the responsibility on the latter.

This debate reflects the fact that, in many countries, the necessary political and methodological changes must be conceived of as part of a multistage programme, with an emphasis on ethics and halting human-rights violations. If these measures had been taken in the past, this uncomfortable discussion would not be necessary and Brazil could focus on strengthening the science underlying its health-care system.