Federal transfers to Brazil's comunidades terapêuticas, private facilities that treat alcohol and drug dependence through abstinence and long residential stays, jumped from R$ 6.2 million in the first half of 2024 to R$ 33.3 million in the same period of 2026, an increase of 437%. The figures come from a report by Desinstitute, a human rights and mental health organization, and were reported by Folha de S.Paulo. According to the report, the growth is happening without public indicators showing whether the model works.
The study drew on open data from the federal Transparency Portal, extracted on July 1, 2026, and covered 165 institutions with 4,555 publicly funded beds. Among the indicators that are not publicly available are occupancy rates, readmissions, referrals to the health network and deaths occurring inside the facilities. One caveat applies: the data gap makes it impossible to confirm or to rule out the model's effectiveness, because there is simply no official evaluation of outcomes. For the report's authors, the problem is precisely paying without measuring.
"The government has, in practice, been paying for the availability of beds, not for proven care results," psychologist Lúcio Costa, Desinstitute's executive director, told Folha. In his assessment, the lack of efficacy criteria should block the expansion of beds and the continuation of the transfers themselves.
What the numbers do not capture appears in individual accounts. Eduardo Real, 39, went through 14 stays in therapeutic communities over 15 years, in a cycle between crack use and homelessness. He told Folha he suffered beatings, forced labor, homophobia and religious racism against his candomblé faith. Since 2020 he has been treated at a Caps, the community psychosocial care centers that anchor Brazil's public mental health network, under a harm reduction approach, and has gone seven years without drug use or internment. He is now a public health master's student at the University of São Paulo and helped found the National Movement of Victims of Therapeutic Communities in 2022. These are personal testimonies, with no representative sampling, but they converge with findings from earlier inspections.
In a study released in June 2025, Desinstitute analyzed 251 news reports published throughout 2023 and cataloged allegations ranging from unlawful imprisonment and forged medical prescriptions to slave-like labor, medication without consent and compulsory internment without a medical report or court order. Inspections by the MNPCT, Brazil's federal torture prevention body, have found bedrooms with external locks and wooden beams barring doors at a therapeutic community in Guarulhos, in São Paulo state, as shown in images reproduced by Folha.
Where to seek help
For those seeking treatment, the public network offers the Caps and the Caps AD units, which focus on alcohol and drug care with free outpatient services through the SUS, Brazil's universal public health system. The nearest unit can be located through the municipal health department. Reports of mistreatment, unlawful confinement or forced labor in therapeutic communities can be filed through Disque 100, the federal human rights hotline, or directly with state prosecutors.