Perspectivas de la salud mental en el escenario laboral: anatomía de un debate académico / Perspectives of mental health in the workplace: anatomy of an academic debate

La educación en salud mental en el contexto laboral tiene un papel protagónico en la actualidad y responde a una problemática de la salud y del desarrollo social y económico. Persiste el aumento en la prevalencia de problemas y trastornos mentales en los trabajadores con la carga económica concomitante. No obstante, en la academia, concurre la falta de consenso en su concepción, derivado de una pluralidad de perspectivas epistemológicas en pugna, desde las cuales se aborda. El objetivo de este artículo es describir las principales perspectivas epistemológicas que sustentan las concepciones de salud mental laboral, presentadas en artículos y documentos publicados entre 1987 y 2017. La búsqueda de la literatura abarcó la consulta a bases de datos regionales teniendo en cuenta términos (descriptores en Ciencias de la Salud), la consulta manual, y la literatura especializada de organismos internacionales de la salud y la economía. En el análisis, los hallazgos se reunieron por coincidencia temática, derivándose tres categorías: la salud mental en el trabajo y el estado de cosas; la centralidad de la salud mental laboral para el desarrollo, y la falta de consenso. El análisis teórico se abordó a la luz de dos grandes tradiciones que la filosofía de la ciencia distingue, la explicativa y la comprensiva. Se concluye que una perspectiva de pluralismo dialéctico tiene el potencial suficiente para aproximarse a la complejidad del fenómeno de la salud mental laboral, tanto desde la academia, como de las acciones emprendidas por agentes en favor de mejorar la salud mental laboral(AU)

Mental health education in the workplace has a leading role nowadays and responds to a health and socio-economic development problem. The increase in the prevalence of mental problems and disorders in workers with the concomitant economic burden persists. However, in the academies, there is a lack of consensus in its conception, derived from a plurality of competing epistemological perspectives from which it is approached. The objective of this article is to describe the main epistemological perspectives that support the conceptions of occupational mental health presented in articles and documents published between 1987 and 2017. The literature search included the consultation of regional databases taking into account terms (descriptors in Health Sciences), manual consultation, and specialized literature of international health and economic organizations. In the analysis, the findings were gathered by thematic coincidence, leading to three categories: mental health at work and the state of affairs; the centrality of occupational mental health for development, and the lack of consensus. The theoretical analysis was approached in the light of two great traditions that the philosophy of science distinguishes: the explanatory and the comprehensive. It is concluded that a perspective of dialectical pluralism has sufficient potential to approach to the complexity of the phenomenon of occupational mental health, both from the academy and from the actions undertaken by agents in favor of improving occupational mental health(AU)

Grupo de reflexão em saúde mental relacionada ao trabalho: uma contribuição da psicologia social do trabalho / Discussion group on work-related mental health: a Social Psychology of Work contribution

Resumo Objetivo: apresentar e discutir uma proposta de intervenção grupal com trabalhadores de uma indústria automobilística que apresentavam intenso sofrimento psíquico. Métodos: intervenção com métodos participativos, abrangendo 14 trabalhadores de uma mesma empresa, com queixas de adoecimento físico e mental relacionado ao trabalho. Os participantes compartilharam suas vivências cotidianas relacionadas ao trabalho em um grupo de reflexão, aberto e construído coletivamente, realizado no Centro de Referência em Saúde do Trabalhador (Cerest) de Campinas (SP), ao longo de 11 encontros, durante seis meses. Para estimular a discussão acerca das experiências cotidianas relacionadas ao trabalho e seus impactos sobre a vida e a saúde dos trabalhadores, utilizaram-se estratégias metodológicas como rodas de conversa, dinâmicas e materialidades mediadoras, como filmes, textos e imagens. Resultados: as intervenções no grupo de reflexão geraram discussões sobre temas como trabalho no capitalismo, culpabilização dos trabalhadores pelo adoecimento, suas histórias e seus novos projetos de vida, e a importância da união e da solidariedade entre eles. Conclusão: o grupo auxiliou no desenvolvimento de reflexões críticas pelos trabalhadores, fazendo-os se sentir menos culpados, mais fortalecidos, unidos, solidários entre si e mais ativos na busca por transformação das condições e da organização do trabalho.

Abstract Objective: to present and discuss a group intervention proposal involving workers from a car industry who were experiencing intense psychical suffering. Methods: participative intervention with 14 workers employed in the same company who complained about physical and mental work related illnesses. The participants shared their work-related daily experiences in an open and collectively built discussion group; 11 meetings were held for six months at the Occupational Health Reference Center (Cerest) of Campinas, SP, Brazil. Methodological strategies, such as conversation circles, dynamics and mediating materialities (films, texts and images), were adopted to stimulate the discussion on daily work-related experiences and their impacts on workers' life and health. Results: the interventions in the discussion groups instigated discussions on topics such as work under capitalism, workers' culpability regarding their illnesses, their stories and new life projects, and the importance of their union and solidarity. Conclusion: the group helped the workers to develop critical reflections, to feel less guilty, stronger, more united and solidary with each other, as well as more active in their search for changing work conditions and organization.

Salud mental relacionada con el trabajo: desafíos para las políticas públicas / Work-Related Mental Health: The Challenges for Public Policies

A pesar de que las estadísticas de diversos países indican un aumento significativo de los casos de trastornos mentales relativos al trabajo, las intervenciones propuestas por gobiernos y organizaciones internacionales comúnmente se limitan a los "factores de riesgo psicosocial", con foco en la prevención del estrés. Así las cosas, las acciones son poco críticas frente a los escenarios económicos, políticos y sociales. Este artículo presenta una propuesta más amplia para afrontar los problemas de salud mental ocasionados o agravados por la actividad mental desde el abordaje teórico-metodológico de la Salud Mental relacionada con el Trabajo. Se exponen, asimismo, los principios del campo de la Salud del Trabajador, que hace parte de la política de salud pública brasilera y que orienta actualmente la realización de intervenciones.

Although statistics from various countries indicate a significant increase in cases of work-related mental disorders, the interventions that governments and international organizations propose are often limited to "psychosocial risk factors" and focused on stress prevention. Also, these interventions are uncritically conducted in relation to contemporary economic, political and social scenarios involving work relations. This article presents a more comprehensive proposal to deal with mental health problems caused and/or aggravated by work activity: the theoretical and methodological approach of 'Work-related Mental Health'. Furthermore, the principles of 'Workers' Health field', part of the Brazilian public health policy, are presented as guidance for conducting these interventions.