MOOCS Saúde Mental Relacionada ao Trabalho - 23 - Atenção integral em saúde mental e trabalho

After better understanding the dynamics involved in work-related mental suffering, and also knowing how to more clearly identify the risks, the risk situations for the health of the worker, you might ask yourself: well, what can we do in the face of this scenario? From this class on, we will start talking about interventions in work-related mental health. Faced with this scenario we have described throughout the course, we can say with certainty that the strategies for coping with suffering and work-related mental illness need to be inventive, preventive, and interdisciplinary.

it is crucial that we do this work within a network, that we develop collective strategies to transform this suffering into health. In general, according to the World Health Organization, it is important that all institutions and organizations take initiatives that promote well-being, protect mental health and identify early cases of mental illness among workers and provide support and rehabilitation for identified mental health problems. Remembering that prevention is always better than treatment.

It is always better to work within the logic of prevention and health promotion. Thus, we need to emphasize the importance of acting before the disease strikes, and the illness process and the damage has already set in, and we already have an illness process installed. You will be able to follow through the diagram on your screen that we will think of these intervention strategies at an individual and collective level, and in all phases of the dynamic of the illness process.

The phases of health, suffering, and illness. We need to think of strategies for all of these moments of the dynamic, okay? So, in general, for all these three moments, we need to think of actions to promote positive aspects of health promotion and prevention against specific risks.

We've talked so far a little bit about psychosocial risks, some specific chemical hazards that may also be related to the mental illness process. So, it is important to act within the logic of prevention throughout this dynamic of health to illness. When we already have suffering installed - remember that we talked about the dynamics of exhaustion in previous classes?

- it is important to interfere and think of intervention measures in this moment of suffering and illness, which are: early identification, support, and rehabilitation. In the next classes, we will talk a little more specifically about specific measures, and specific interventions. But whatever interventions we are going to think about and structure, they need to stem from some basic assumptions and we're going to talk a little bit about each of these assumptions.

First: work is all that implies the act of working, gestures, know-how, use of the body, mobilization of intelligence and creativity, ability to reflect, interpret, feel, and react to situations. This is our first assumption. It is a very basic assumption: about what work is.

Second assumption: there is always a discrepancy, a difference between something prescribed and the real, concrete situation of the work, that mobilizes the workers in all their knowledge and know-how to fill the difference, the gaps between the prescribed work, and the real work. Third assumption: The nexus between health and work, what we call the causality nexus, is not simple, because the mental illness process is very specific for each individual. It involves their life and work history.

Fourth assumption: Workers are not compartmentalized; Therefore, listening to the worker cannot be compartmentalized either. People suffering from work-related psychological distress might be going through difficult times in their lives outside the workplace. And you can't separate the body of the worker that goes to work from the father, the husband, the uncle, or the son.

Fifth assumption: the non-recognition of work-related illness can in itself be an additional source of suffering. The fact that we are unable to recognize an illness process as being work-related, as having its source at work. The sixth assumption: oftentimes, even the workers themselves are not aware that an illness process stems from their work, that there are work-related causes involved.

In many cases, these illness situations that appear at work are often considered, by colleagues and management, as a weakness, a dissimulation, making the worker feel even more responsible and guilty for their illness. The seventh assumption is: it is not uncommon for these situations of suffering to accompany physical limitations, due to an illness, or accident at work. Eighth assumption: the contribution of work to the alteration of mental health derives from a range of aspects, from specific factors, such as exposure to toxic agents - as we saw in some of our previous classes – to the complex articulation of factors related to the organization of work.

Given this range of assumptions, these eight assumptions we have seen here, which are important to consider in whatever intervention we propose in work-related mental health, there is a fundamental issue following the principles of the approach to workers' health, which we saw in module two, within this concept of what we understand as workers’ health: which is that work-related mental healthcare presupposes the recognition that the worker is a singular, unique subject with knowledge about his or her work and about their illness process. It is the worker who will know what is happening at work, and know how to recognize what processes may be causing that ailment. Thus, regardless of the theoretical, or methodological approach, it is important to recognize that the comprehension of health issues is given through the experience and knowledge that the workers have about their daily work.

It is important to recognize that the worker is the one who will have the grasp and the knowledge about their daily work routine, and how it interferes with their mental health. Considering what we talked about so far, we reinforce that it is necessary to act before illness and suffering set in, as well as when it has already occurred. So, in our next class, we will talk about interventions within the logic of health promotion and prevention.

Until the next class!