From Trieste to Rio: Marco Cavallo and the Afterlives of Deinstitutionalisation

What does psychiatric deinstitutionalisation look like when approached not primarily through law, policy, or institutional archives, but through wet streets, samba rehearsals, cigarette breaks, improvised costumes, and the smell of rain-soaked bodies returning to a psychiatric hospital after a parade? This question guided me during ethnographic fieldwork carried out in Rio de Janeiro over the course of a month and a half during the 2026 carnival season. During that period, I moved between rehearsals, group meetings, costume workshops, samba competitions, blocos (a community-based Carnival street parade), exhibitions, and long conversations with workers, users, artists, and coordinators linked to the mental health network in the city.

In the Brazilian context, psychiatric deinstitutionalisation did not unfold only through legal reform, policy shifts, or the gradual construction of community-based services such as the Centros de Atenção Psicossocial (CAPS). It also took shape within a society where collective ritual already provided a way of negotiating marginality, difference, and public visibility. Carnival, in this sense, is more than a festive backdrop: it is a medium through which bodies often treated as excessive, unruly, or “out of place” enter the street embracing a different protagonism, without being immediately reduced to pathology. It is within this broader terrain that the Brazilian anti-manicomial movement (a movement of users, activists, workers, and families fighting against asylums) found one of its most powerful public languages. In and around Rio de Janeiro, this takes multiple forms, including the bloco Loucura Suburbana (Suburban Madness) in Engenho de Dentro, the bloco Império Colonial (Colonial Empire) in the former Instituto Juliano Moreira, the bloco Zona Mental (Mental Zone) in Bangu, the bloco Tá Pirando, Pirado, Pirou! (Going Crazy, Gone Crazy, Lost It!), and the parades organised by different mental health services such as CAPS Miriam Makeba.

The clearest place to begin is perhaps Loucura Suburbana, which began more than twenty-five years ago from a simple impulse: users inside the Nise da Silveira Institute (a psychiatric institution) wanted to celebrate carnival. The institution is inseparable from the legacy of Nise da Silveira, a crucial, pioneering figure in Brazilian psychiatric reform who rejected violent interventions and placed affect, artistic expression, and occupational therapy at the center of care. Loucura Suburbana thus emerged in a space already marked by a counter-tradition within psychiatry, one that sought to replace coercion with relation and control with expression.

What began as a festive initiative gradually became something more enduring. In an institution still shaped by hierarchy and enclosure, carnival created new forms of encounter, and over time the bloco generated workshops, editorial projects, computing classes, costume-making, and other collective practices that extended its logic throughout the year. It became less an event than a social infrastructure of participation, creativity, and recognition.

That longer history could be felt on the street. The parade did not seem imposed onto the neighborhood of Engenho de Dentro (where the psychiatric institution is located), but already claimed by it. The density of care, participation, and mutual attentiveness gave the bloco a life of its own. What emerged there was more than a festive performance: it was a collective form sustained by small gestures, shared presence, and the constant reworking of who protects, who participates, and who holds the group together. It was in this sense that I came to think of it as um “bloco com alma”, a Carnival parade with a soul.

Loucura Suburbana also shows how deeply deinstitutionalisation depends on territory. In Engenho de Dentro (a suburban, historically marginalised neighbourhood in Rio de Janeiro’s North Zone), the hospital had long shaped neighborhood memory through fear and stigma. The bloco did not erase that past, but slowly displaced it through repeated public occupation and the transformation of spaces once associated with confinement into places of music, costume, and encounter. What it makes visible, then, is that psychiatric reform is not only about changing services. It is also about transforming the social bond, and about making another way of living together seem ordinary.

This intuition is not unique to Brazil. It had also shaped Trieste in the early 1970s, where deinstitutionalisation meant more than reorganising services: it required transforming the asylum from within, replacing the rigid order of confinement with forms of creative disorder, while also confronting stigma outside and building communities of care in public space. It was in this atmosphere that, on 25 February 1973, a large blue horse crossed the gates of the San Giovanni psychiatric hospital, followed by more than four hundred patients. Built collectively by patients, nurses, doctors, and artists under the guidance of Vittorio Basaglia (artist and sculptor, who participated in the closing of the asylum, as well as being a cousin of Franco Basaglia), Marco Cavallo became the symbol of the struggle for the closure of psychiatric hospitals in Italy. Inspired by a real horse that had carried laundry inside the asylum, it has often been described as a Trojan horse in reverse: brought out from within a walled institution not to conquer the city, but to free those confined inside.

In 2026, that same horse crossed the threshold of the Hospital Psiquiátrico Philippe Pinel in Rio, setting off a wave of excitement. People shouted, clapped, and whistled as the chant “Tá pirandoooo!” (“it’s going crazyyyy!”) spread through the crowd. As the bloco exited the gates, one participant climbed onto the side of a taxi stopped in traffic and began dancing, while another stood in the middle of the road, informally directing cars around the parade. For a few moments, the hospital gate ceased to function as a line of containment and became instead a point of passage through which collective energy spilled into the city.

Marco Cavallo’s arrival in Rio was made possible by Tá Pirando, Pirado, Pirou!, a carnival bloco that emerged in the early 2000s at the intersection of psychiatric reform, university-based mental health work, neighborhood organizing, and Rio’s revival of street carnival. Its roots lie partly inside the Hospital Philippe Pinel, where workers had long organized carnival dances for inpatients. The turning point came in 2004, when an internal procession suggested another possibility: not simply celebrating inside the institution, but moving beyond it. From there, the bloco took shape through the convergence of actors linked to Pinel, the Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, the Instituto Franco Basaglia, and a neighborhood association on Rua Lauro Müller. Even its name emerged collectively, from a phrase proposed during a voting process: carnival should not be only for those who had already “gone mad,” but also with those who were “still going mad” outside. From the beginning, Tá Pirando was imagined as a collective intervention at the boundary between institution, street, and community.

What made the bloco Tá Pirando parade especially compelling, however, was not only this symbolic crossing, but the way it condensed multiple political layers. The bloco’s T-shirt – collectively imagined but illustrated by Samy das Chagas – visually embodied this mixture. The illustration integrated Marco Cavallo in a collective constellation of multiple characters, including the portrait of Gilson Secundino, one of the bloco’s founders and the person who coined its name. On the back, he explained, the image shifts to the explicit homage: Franco Basaglia with Franca holding a megaphone, alongside other recurring mascots and carnival figures – the “madame” and the “passista” – so that the tribute to reform is inseparable from the bloco’s own popular repertoire. In Samy’s account, this is exactly the point: the design comes from conversations with others in the group, insisting on grounding Basaglia in the local mixture that the bloco has cultivated for years – reform not as something imported and kept intact, but as something recomposed in Rio’s own visual and political language.

Similarly, what distinguished the 2026 Marco Cavallo most visibly, however, was its “decolonised” form. It was adorned with fitas do Bonfim – Afro-Brazilian devotional ribbons tied with wishes and promises – and it paraded alongside Iemanjá, the Afro-diasporic divinity of the sea. This was not decorative syncretism. It was epistemological repositioning. Rather than importing Basaglia as a European model to be implemented, the Brazilian anti-asylum movement layered his legacy within Latin American histories shaped by enslavement, resistance and spiritual/ontological plurality.

Reform in Brazil unfolded within a broader constellation of struggles that exceed the boundaries of mental health policy. The horse that once emerged from San Giovanni as a symbol of the struggle against confinement and institutional violence moved through Rio alongside banners and estandartes denouncing feminicide and affirming women’s lives, bearing messages such as “aqui la tristeza pula de alegria” (“here sadness leaps with joy”), “meu corpo minhas regras” (“my body, my rules”), “nem un passo atrás, manicômio nunca mais” (“not one step back, asylums never again”), and “arte é cura” (“art is healing”). This layering was visible again in the long banner carried during the parade, filled with desires which had been painted by the participants of the bloco. Like the notes once placed inside Marco Cavallo in Trieste in 1973, the banner in Rio contained personal and political longings: work, dignity, recognition, but also calls for world peace. Local demands coexisted with global anxieties, while intimate aspirations met planetary concerns. The similarities with the desires written in the 1970s are striking. The vocabulary of longing persists. And yet, when carnival ends, the paradox returns. Marco Cavallo crosses the gates of Pinel and enters the street. For a few hours, the institution becomes threshold rather than enclosure. Roles loosen, diagnostic identities soften, strangers embrace. The street becomes therapeutic territory. At night, the horse is wheeled back inside. Carnival does not abolish the asylum but it reveals its fragility. It rehearses another arrangement of care – collective, aesthetic, relational – and leaves a trace.

Marco Cavallo crossed the gate in Trieste in 1973. In Rio in 2026, it crossed again. Marco Cavallo may return behind institutional walls, but it does not return unchanged. It carries Bonfim ribbons knotted with promises, songs insisting that freedom in treatment is for everyone, and the repeated affirmation that no one walks alone. What carnival makes visible cannot be entirely folded back into routine; it settles in relationships, services and neighbourhoods. Deinstitutionalisation is not a single act, but a practice repeated and adapted. If Marco Cavallo was once a theatrical machine of liberation, then now is also a living archive of crossings – widening, each time the gate opens, the space of freedom.