Hello! So far, we have talked about three important points in the evaluation and assistance to workers. Basic premises, the suspicion of a relationship with work, and assessment of the clinical condition and its causal relationship.
But, as we have been discussing throughout the course, the intervention strategies need to be thought of in an integrated, and collective way, in which the workers are perceived in all their dimensions. Thus, it is often not enough to provide support to the sick worker alone. We need to understand their social, cultural, family, and work contexts, and consider joint strategies for prevention, promotion, assessment, and assistance.
Within this logic, in order to meet the needs of workers requiring mental health care, the articulation of different actors from different institutions may often be necessary. For example, a worker might present chronic alcoholism with a work-related component. It could be a shift job, with a lot of tension, and a lot of stress.
We can affirm that psychological support for this worker may be important, but it might not be enough if we are not able look at this worker in all of his or her dimensions. Does that worker have close family members, a support network, do they have other alcoholic family members? Is this worker able to reduce their work pace or are they the sole breadwinner of the family and, therefore, cannot reduce the pace of their work?
What is the cultural context in which this worker lives and socializes? Alcohol is often an important component in social relations and fraternization with friends. Therefore, we need to realize that a punctual intervention, even if that illness is work-related, may also not be enough.
We refer to the promotion, prevention, recovery, and rehabilitation considering the workers in their entirety and complexity, and considering the importance of work in mental health, but not limited to it, as Comprehensive Health Care. In this specific case, Comprehensive Care in Mental Health and Work. Within this logic of comprehensive care in mental health and work, in cases where there is work-related illness, or work-related distress, there are some specific actions that can be adopted.
In this, and the next class, we will talk a little about five specific actions. They are: Case notification; Guidance regarding the issuance of CAT; Interventions in the context of work, in psychosocial and other risks; Clinical follow-up; And, guidelines and health education. In class 25, we talked about the Occupational Health Surveillance and the notification of grievances, which are of paramount importance for the production of adequate public policies.
The notification of work-related mental disorders are compulsory in the state of Espírito Santo. Therefore, any health professional, either from the public or private network, needs to record this condition in the information system. Here, in Espírito Santo, we call this system e-SUS VS, which replaced the old Information System for Notifiable Diseases, the SINAN, which many of you may know.
Notification is required to promote visibility and understanding of the problem as a public health issue. Here in the state, the number of notifications of work-related mental disorders is quite small. In the case of SINAN, the notification form is filled out by hand and forwarded by the health service to the Municipal Health Surveillance Unit.
In the case of Espírito Santo, since 2020 we have adopted the e-SUS VS system, which is an online system and any professional healthcare service can be registered in this system in order to adequately report all the grievances that require compulsory notification here in the state, including work-related mental disorders. If you want to see the work-related mental disorder notification form, it is available on the SINAN website, remembering that here in state, this record is available only in the e-SUS VS system and we no longer carry out notifications on SINAN, only on e-SUS VS. Who must notify?
We reinforce that any healthcare professional involved in patient care must notify on e-SUS VS. So, any healthcare professional can and should access the system and make the appropriate notification. The State and Municipal Health Surveillance must monitor the notifications registered in the e-SUS VS, in order to ensure that they have complete and adequate information, that the form is properly filled out, and that it corresponds to the reality encountered by the Health Service.
Thus, it is possible to take the necessary actions and ensure a more effective public policy. In addition to notification in the health information system, when a work-related mental disorder is identified, It is also important that if the worker is insured by the INSS, the company opens a CAT, a Communication of Accident at Work. The CAT is an instrument for workers and employers to register work accidents.
Typical ones, from commuting, as well as occupational diseases, as may be the case with various mental disorders, as we have discussed throughout this module. If the worker is insured by Social Security and needs a leave of absence longer than 15 days, he or she must be forwarded to the INSS medical expert. It is important to point out that, if an occupational disease is detected, such as Burnout Syndrome, for example, the worker will receive accident illness assistance.
During this time, the company continues making the FGTS deposit normally and, upon returning, the employee will have stability for one year and other benefits, such as food tickets and even some medical insurance. It is important to remember that we are talking about comprehensive care in mental health and work. And as we said, in many cases, this worker will not only need psychological or medical support, but it will also be necessary to ensure a series of rights and guarantees so they can recover effectively and undergo suitable treatment at the right time.
Among these rights is the CAT, which will guarantee a series of labor rights. Who should open the CAT? The CAT is an obligation of the employer.
If a company refuses to open a CAT, the employees themselves, or even the labor union can open a CAT. It is important that health services produce well-founded reports so that, if a relationship between work and illness is found, it should be well-described in the medical report. The health services seeing the worker must issue a very well-founded and detailed report, so that if a relationship between the work and the illness is identified, this relationship is well described in the report.
The report can also be produced in a multidisciplinary way, not just from a physician, but often from psychologists, physiotherapists or social workers as well. In the next class, we will discuss another of the necessary actions to ensure comprehensive care in mental health and work. Interventions in the context of work, psychosocial and other risks.
Until the next video!
