Hello! In the last class, we talked about the importance of providing comprehensive care in mental health and work. Which means ensuring a set of promotion, prevention, recovery, and rehabilitation practices at individual and collective levels considering workers in all their dimensions and life contexts.
We talked about the notification of cases in the health information systems, e-SUS VS, and also about CAT, the reporting of accidents at work. In this class, we are going to talk about interventions in the context of work. It is important to remember that all the actions proposed here throughout the course need to be considered in a transversal and complementary way, guaranteeing what we are calling comprehensive attention and care.
In this sense, to ensure comprehensive health care for the worker, it might be important that the workplace where this worker is getting sick, or is exposed to various types of risk it might be important that this workplace be inspected, that it is looked at. This is an action that can be carried out by the SUS, either through the Occupational Health Reference Center, the Cerest. Through technical references in occupational health surveillance.
Or even through the health surveillance. Services, such as primary care, and even mental health services can also be involved in this analysis of workplaces in order to identify the psychosocial risks existent at work. It is important to remember that the interest and responsibilities of the SUS in ensuring healthy working environments are set out in Law 8.
080, of 1990, as well as in the National Workers' Health Policy, and in various municipal and state health codes. And at what point does this analysis, inspection, and surveillance of work environments and processes need to be carried out? How do we identify the need for workplace surveillance?
We spoke in the last class about the importance of reporting work-related mental disorders. This can be one of the ways to initiate and identify the need of an inspection. Through monitoring the e-SUS VS database.
The existence, for example, of any notification registered there, or multiple notifications in the same workplace. For example, if I can identify in my database, in my information system, that there are multiple notifications of work-related mental disorders in a specific productive sector, or in a specific workplace, like for example, a specific health unit, or in a specific industrial sector, I can identify the need for inspection of that workplace. Inspections in work environments and processes can also be carried out based on complaints.
For example, from an ombudsman, or complaints made to the Public Ministry or the Ministry of Labor. It is common for health services and departments to receive these complaints. This can be an important source of information.
The territory’s health services may also point to the need for inspection in certain work environments. If, for example, a particular health service reports or identifies that it has received several workers from the same workplace with a very similar complaint. For example, it is possible that a particular health unit is receiving recurring cases of intoxication among workers of a particular industry.
It can be an indication or a flag that this workplace needs to be inspected. Another interesting way to identify the need for inspection of workplaces is through mapping the territory, the production sectors existing in that territory. Identifying those productive sectors that we already know have higher levels of mental illnesses, such as, banks, commerce, and public services.
If that territory has a large number of these services, of these productive sectors, inspections may be carried out, including those of a preventive or guiding nature. Inspections in work environments and processes with a focus on mental health are the responsibility of the SUS, and can count on several partners. The Health Surveillance, Cerest, Primary care, and mental health services.
It can also count on partners beyond the health sector, such as unions, the Public Ministry, Regional Labor Superintendency, depending on the severity and type of case to be investigated. During inspections, It is important to talk to employers and workers whenever possible. Normally, the person who receives the inspection team is a manager or even an employer.
But listening to what the worker has to say is fundamental. But it is also important to ensure that workers can be heard preserving their privacy, without exposing them to their boss or employer. This is why when an inspection team is a little bigger, this dialogue, this conversation with the worker can be a little easier.
During the inspection, it is also important that this team seeks to understand aspects of the work organization. How does the work occur in that workplace? How are the relationships between the managers?
How are the shifts, break times, and interpersonal relationships? In addition to the organization of work, it is also important to investigate the risk factors. Namely: ergonomic, chemical, and especially psychosocial factors directly linked to the organization of work.
That is why, before carrying out an inspection, the team conducting it must be very clear about the occupational and psychosocial risks, and the organization of work so that the inspection can be more effective. As we have said throughout the course, these aspects of work organization, and often the psychosocial risks present in that work organization are not easily identifiable. Such as, for example, a physical risk.
Like a very loud noise, or a chemical risk. A very strong odor from a chemical product. Therefore, it is possible that this inspection team will need to return to the workplace as many times as necessary to be able to clearly identify aspects of the work organization, and the existing risks to workers’ mental health.
Here in the course, you will find a number of materials that can help you prepare, study, and set up an inspection team focusing on mental health and work. We also recommend reading the “Work and Mental Health Care Protocol” of the State of Bahia. It is included in the course as complementary material and it is a very complete material, with instruments, tools, and scales that will help identify the existent psychosocial risks at work.
In our next and final class of the Work-Related Mental Health course, we will address the last two specific behaviors, thinking about this logic of comprehensive care for work-related mental health. Until then!
