[Philanthropy, privatization, and reform: psychiatric assistance scenarios in the state of Paraná]

The article discusses different psychiatric assistance arrangements in Paraná from the earliest years through today, taking into account the state's unique features and relations with national policies. This assistance was first provided in 1903, when the Hospício Nossa Senhora da Luz philanthropic asylum was founded. It was only in 1954 that Hospital Colônia Adauto Botelho, the state's first public hospital, began operations. In the 1960s, the Paraná government signed agreements with private hospitals for more beds in the interior, accelerating the provision of psychiatric assistance and fostering a privatization approach. This strategy led to the current situation in Paraná, where specialized hospitals are the rule, despite the existence of other facilities foreseen under the psychiatric reform legislation.