Rio de Janeiro (AFP)

Around a psychiatric hospital in Rio de Janeiro, it is difficult to distinguish patients from other revelers in the midst of carnival madness.

For 20 years, the Nise da Silveira Municipal Institute, a benchmark hospital in Brazil, has opened its doors for the Loucura suburbana procession (the madness of the suburbs), in Engenho de Dentro, a popular district in the north of Rio.

The happy parade brings together several hundred people, including patients, family members, nursing staff and onlookers.

Multicolored costumes, glitter galore, no samba dance from the top of stilts: an authentic "bloco", musical procession like there are dozens of others in Rio, but with a real spirit of inclusion and enhancement of diversity.

"Who is crazy and who is not crazy in our society? That's carnival: everyone brings out their madness", said to AFP Adriana Carvalho Lopes, a 46-year-old teacher disguised as a devil, with horns, a trident and a red cape.

"People who call themselves normal think that patients do not have dreams, that they live in a world apart, but they are also very creative," added her husband Bruno Coutinho, 42.

Adriana and Bruno dance to music punctuated by around forty percussionists, most of whom are hospital patients.

In the bass drum, Renata Alves, 23. A victim of sexual abuse at the age of six, she had drug problems and attempted suicide.

"The procession saved me. Here I have made friends, I have a family," she says.

Since 2016, she has been attending a Psychosocial Care Center (CAPS), an open mental health unit, which receives patients who live outside and only go to the hospital for consultations or to practice any kind of activities.

Throughout the year, she takes part in a music workshop, where she learns to play percussion, but also to write, compose and even draw.

"I really like these cultural activities. When I had crises, I wrote verses on what I felt, I drew," she says.

- Pioneering therapies -

Art therapy to cure mental illness is a legacy of the psychiatrist Nise da Silveira, who gave her name to the hospital, formerly called Pedro II.

Disciple of Jung, she worked there in the 1940s, refusing to follow the practices of the time such as lobotomy or electroshocks. Instead, his patients were introduced to the visual arts.

"Art helps stimulate the unconscious and helps in the healing process," says psychologist Ariadne Mendes, 69, co-founder of Loucura suburbana.

"Previously, patients were isolated from their families, from society. They were locked up, hidden," she continues.

Since 2010, the Loucura suburbana Cultural Center, which has premises in the hospital, has offered activities for all people in the neighborhood, and not just patients, with free music, percussion and computer science.

"Music is a tool to unite people, promote diversity and build new solidarity," says musician Abel Luiz, 37, in charge of the musical workshop.

Adilson Nogueira, 62, composer of Loucura Suburbana, has already been hospitalized several times. Currently in treatment in a CAPS, he never wants to be interned again.

"We sleep on the ground, we are prisoners, like animals. We only see the family once a week," recounts this retired worker, married and father of three.

"At CAPS, the treatment is much better, because people give us affection and we are free to go home afterwards. Here, I discovered freedom and culture," he says.

It was he who was the proud standard bearer of the Loucura suburbana procession this week, a few days before the parade in Rio de Janeiro of samba schools, the highlight of carnival in the "wonderful city".

© 2020 AFP