Workers' Health Reference Centers performance in mental health: a survey in Brazil

Cardoso, Mariana de Castro Brandão; Araújo, Tânia Maria de

doi:10.1590/2317-6369000118115

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Revista Brasileira de Saúde Ocupacional

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Article • Rev. bras. saúde ocup. 41 • 2016 • https://doi.org/10.1590/2317-6369000118115 copy

Workers' Health Reference Centers performance in mental health: a survey in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction:

nowadays mental disorders constitute the third cause for workers' leave.

Objective:

to identify main initiatives in work-related mental health carried out by Workers' Health Reference Centers (CEREST).

Methodology:

descriptive study using online survey conducted with CERESTs in Brazil in 2014.

Results:

80.1% (n = 161) of the eligible CERESTs took part in this study. Most of them (87.5%) were operating for more than five years, 89.2% were managed with resources from the National Network of Integral Attention in Occupational Health (Renast), 61.3% had good infrastructure and 67.7% had trained staff in mental health care. However, 63.5% did not have social control, only 46.9% provided ambulatory care, 47.8% developed health education activities in Psychosocial Attention Center (CAPS), 40.9% carried out matrix support initiatives, 18.7% had a therapeutic group, 35.5% developed constantly informative activities, 53.2% carried out work environment inspections and 58.8% made a systematic record work-related mental disorders cases in the Notifiable Diseases Information System (SINAN).

Conclusion:

we observed that work-related mental health initiatives carried out by CERESTs are still incipient.

Keywords:
occupational health; mental health; Brazilian Unified Health System; mental disorders

Characteristics (N)	Total		State		Regional
	N	%	n	%	n	%
Time of operation
0 to 4 years	19	12.5	-	-	19	14.5
5 to 8 years	63	41.4	3	14.3	60	45.8
9 to 12 years	59	38.8	15	71.4	44	33.6
Over 13 years	11	7.3	3	14.3	8	6.1
Facilities (160)
Excellent / good	98	61.3	14	56.0	84	62.2
Regular	47	29.4	7	28.0	40	29.6
Poor / terrible	15	9.3	4	16.0	11	8.2
Permanent materials and equipment (161)
Excellent / good	105	65.2	16	64.0	89	65.4
Regular	44	27.3	6	24.0	38	27.9
Poor / terrible	12	7.5	3	12.0	9	6.7
Financial Resources (158)*
Renast	141	89.2	20	80.0	121	91.0
State Secretariat of Health	26	16.4	13	52.0	13	9.8
Municipal Secretariat of Health	42	26.5	-	-	42	31.6
Others	17	10.7	3	12.0	14	11.2
Acting management council (159)
Yes	39	24.6	3	12.5	36	26.7
Under planning or implementation	19	11.9	2	8.3	17	12.6
No	101	63.5	19	79.2	82	60.7
Acting CIST (157)
Yes	82	52.2	19	86.4	63	46.7
Under planning or implementation	49	31.2	2	9.1	47	34.8
No	26	16.6	1	4.5	25	18.5

Characteristics (N)	Total		State		Regional
	N	%	n	%	n	%
Professionals who make up the team (161) *
Administrative assistant	113	70.2	18	72.0	95	69.9
Driver	93	57.8	16	64.0	77	56.6
Nursing technician	107	66.5	20	80.0	87	64.0
Occupational safety technician	91	56.5	10	40.0	81	59.6
Nurse	142	88.2	24	96.0	118	86.8
Social worker	92	57.1	18	72.0	74	54.4
Physical therapist	108	67.1	16	64.0	92	67.6
Psychologist	102	63.4	16	64.0	86	63.2
Occupational physician	115	71.4	19	76.0	96	70.6
General practitioner medical doctor	42	26.1	6	24.0	36	26.5
Psychiatrist	6	3.7	2	8.0	4	2.9
Health physician	25	15.5	17	28.0	18	13.2
Engineer	44	27.3	11	44.0	33	24.2
Others	58	36.0	14	53.8	44	32.3
The team is compatible with tasks performed according to existing legislation (158)
Always / often	99	62.6	15	62.5	84	62.7
Sometimes	34	21.6	6	25.0	28	20.9
Rarely / never	25	15.8	3	12.5	22	16.4
The team is compatible with demands (160)
Always / often	71	44.4	11	45.9	60	44.1
Sometimes	52	32.5	8	33.3	44	32.4
Rarely / never	37	23.1	5	20.8	32	23.5
Have a trained professional in mental health care (160)
Yes	109	68.3	15	60.0	94	69.6
No	51	31.7	10	40.0	41	30.4
Which are these professionals (108) *
Physician	36	33.3	7	46.7	29	31.2
Psychologist	94	87.1	12	80.0	82	88.2
Occupational therapist	13	12.0	4	26.7	9	9.7
Nurse	24	22.2	5	33.3	19	20.4
Social worker	19	17.6	6	40.0	13	13.4
Physical therapist	11	10.1	2	13.3	9	9.7
Other**	8	7.4	1	6.7	7	7.5

Initiatives (N)	Total		State		Regional
	N	%	n	%	n	%
Occupational health care
Conducts procedures in mental health for assessment and WRMD connection with work (160)*
Yes	75	46.9	5	20.0	70	51.9
Under planning or implementation	18	11.2	3	12.0	15	11.1
No	67	41.9	17	68.0	50	37.0
For treatment of WRMD* workers are referred to which service (135)**
CAPS	96	71.1	12	70.5	84	71.2
SUS network mental health outpatient clinic	65	48.1	6	35.2	59	50.0
Basic care	41	30.3	5	29.4	36	30.5
CEREST	38	28.1	4	23.5	34	28.8
Private mental health treatment	22	16.3	4	23.5	18	15.2
Others	6	4.4	2	11.7	4	3.3
Performs initiatives or information campaigns in Mental Health and Work for workers in general (158)
Always / often	56	35.5	11	44.0	45	33.8
Sometimes	57	36.0	7	28.0	50	37.6
Never / rarely	45	28.5	7	28.0	38	28.6
Performs permanent education in occupational health at CAPS (138)
Yes	66	47.8	9	42.9	57	48.7
No	72	52.2	12	57.1	60	51.3
Performs permanent education in occupational health at mental health outpa tient clinics (138)
Yes	36	26.0	4	19.1	32	27.3
No	102	74.0	17	80.9	85	72.7
Matrix support in Mental health
Ensures matrix support in Mental Health and Work for SUS services (159)
Yes	65	40.9	11	45.8	54	40.0
Under planning or implementation	45	28.3	5	20.8	40	29.6
No	49	30.8	8	33.4	41	30.4
In which services (82)**
CAPS	51	62.6	6	50.0	45	64.3
Mental health outpatient clinics network	31	37.3	4	33.3	27	38.0
Basic care services	74	90.2	7	58.3	67	95.7
Emergency and urgent services	39	47.6	4	33.3	35	50.0

Initiatives (N)	Total		State		Regional
	N	%	n	%	n	%
Carry out inspections in work environments for investigation of exposure to psychosocial risks factors (156)
Always / often	83	53.2	14	58.3	69	52.3
Sometimes	12	7.7	1	4.2	11	8.3
Never / rarely	61	39.1	9	37.5	52	39.4
Notifies WRMD cases* in SINAN (160)
Yes	94	58.8	11	44.0	83	61.5
Under planning or implementation	22	13.8	3	12.0	19	14.1
No	44	27.4	11	44.0	33	24.4
There are services on SUS care network qualified for making this notification (143)
Yes	91	63.6	17	80.9	74	60.6
No	52	36.4	4	19.1	48	39.4
Which are these services (91)**
CAPS	65	71.4	14	82.4	51	68.9
Mental health outpatient clinic	42	46.1	9	52.9	33	44.6
Basic care services	50	54.9	9	52.9	41	55.4
There are services on SUS care network making this notification (135)
Yes	66	48.9	12	80.0	54	45.0
No	69	51.1	3	20.0	66	55.0
Which are these services (66)**
CAPS	32	48.8	6	50.0	26	68.4
Mental health outpatient clinic	12	18.2	2	16.7	10	26.3
Basic care services	32	48.8	6	50.0	26	68.4
Make these notifications known by newsletters or reports (160)
Yes	29	18.1	8	32.0	21	15.6
Under planning or implementation	46	28.8	7	28.0	39	28.9
No	85	53.1	10	40.0	75	55.6

Fundação Jorge Duprat Figueiredo de Segurança e Medicina do Trabalho - FUNDACENTRO Rua Capote Valente, 710 , 05409 002 São Paulo/SP Brasil, Tel: (55 11) 3066-6076 - São Paulo - SP - Brazil
E-mail: rbso@fundacentro.gov.br

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[1] Contato: Mariana de C. B. Cardoso E-mail: cardoso_mariana