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[在巴西精神科改革背景下从事心理健康服务工作:一项技术、政治和伦理挑战]

[Working in mental health services in the context of Brazilian psychiatric reform: a technical, political and ethical challenge].

作者信息

Sampaio José Jackson Coelho, Guimarães José Maria Ximenes, Carneiro Cleide, Garcia Filho Carlos

机构信息

Grupo de Pesquisa Vida e Trabalho, Centro de Ciências da Saúde, Universidade Estadual do Ceará, Fortaleza, CE.

出版信息

Cien Saude Colet. 2011 Dec;16(12):4685-94. doi: 10.1590/s1413-81232011001300017.

Abstract

This paper deals with mental health taken within the context of Brazilian Psychiatric Reform and profiling the transformations in the organization of work processes. This has occurred as a result of the advances with respect to the implementation of the services that replaced the classic psychiatric model and the reconfiguration of the scope of intervention and practices. From this standpoint, the paper seeks to pinpoint the contradictions and problems related to this process and its impact on the organization of work processes on the management of services and on worker health. Lastly, strategies are prepared for the purpose of tackling the problem, chief among which are the following: the redefinition of spaces, practices, and the relationships among the different actors, namely managers, workers, and users; the adoption of co-management mechanisms; and clinical-institutional supervision.

摘要

本文探讨了巴西精神科改革背景下的心理健康问题,并剖析了工作流程组织方面的变革。这些变革是由于在实施替代经典精神科模式的服务以及重新配置干预范围和实践方面取得的进展而发生的。从这一角度出发,本文旨在找出与这一过程相关的矛盾和问题,以及其对服务管理和员工健康方面工作流程组织的影响。最后,制定了解决该问题的策略,其中主要包括:重新定义空间、实践以及不同行为主体(即管理者、员工和用户)之间的关系;采用共同管理机制;以及临床机构监督。

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