As (im)possibilidades de gestão da saúde e segurança na atividade assistencial ao paciente em sofrimento psíquico no CAPS

Abstract

In the field of mental health and psychosocial care, the worker provides assistance to a subject in psychological distress, because here the disease is placed in parentheses to deal with the subject in his experience of suffering or discomfort. This strategy is a break with the theo-retical-conceptual model of psychiatry that adopted the reference of the natural sciences to un-derstand subjectivity and started to objectify and objectify the subject and human experience when dealing with diseases. The Psychosocial Care Centers (CAPS), in which professionals from different categories work in the care of patients with mental suffering, have a unique prac-tice that is characterized by a flexible organization in the reception of people in crisis, by liste-ning to all those involved and for the formation of affective and professional bonds with these people. In this context, this study aims to investigate the (im)possibilities of health and safety management in the face of the established work organization, in the assistance activity for the patient in psychic suffering, of the workers working in the Psychosocial Care Center. (CAPS II) in the interior of Minas Gerais. The methodological approach and the theoretical approach used in this study were based on Ergonomic Work Analysis (AET), through observations (general and systematized) and interviews (open, semi-structured and self-confrontation) and on Ergo-logical, respectively, with the participation of 11 health professionals, both permanent and con-tracted. The results revealed that structural changes had an impact on care, as there is a distance between the organization of the mental health care network advocated by the Psychiatric Re-form and the actual organization. In addition, the clashes and debates established between Men-tal Health x Psychiatry, which appear at the macro level, cross practices and trigger drama in work activities, evidencing, in the meantime, the (im)possibilities of the clinic itself, that is, the impossible of the real (psychoanalytic) present in psychic suffering that is only possible through the engagement of the word. It is noteworthy that in the context of the study, problems related to health and safety have shown that there is a distance between the task and the work activity, which is also amplified by the managerial or technobureaucratic management model based on prescriptions, which, being insufficient, show the (im)possibilities of the void of norms. What happens is that: how you work remains invisibility and the division of work in the way it is carried out is also the division of risks, responsibilities for accidents, diseases, malfunctions. The possibilities, in this sense, are in the changes in the management method: which can cover the precarious working conditions pointed out by professionals and the organization, whose consequences are visible through the high turnover of professionals in the service, which gene-rates the fragment of the collective and prevents dealing with the risk of violence satisfactorily. Because, if this field of possibilities is expanded, the worker, with his knowledge and values, will have better conditions to recreate his environment and renormalize to manage the activity and the present risks, guaranteeing a healthy and safe environment and improvements in the care of the suffering patient psychic.