Mental health agenda for business: an occasion for inquiring into individualized and individualizing measures

Abstract

Introduction  the insufficient appeal by companies to individualized and individualizing measures, without any intervention in the organization of work, is ineffective as a way of mitigating the devastating effects of the COVID-19 pandemic on the mental health of workers and the population in general.

Objective  to recommend measures of a different nature for companies, guided by an expanded conception of clinical practice, the science of the psychosocial dimensions of the health-disease process, and the consideration of the socialization of suffering in workspaces.

Methods  literature review of important discoveries in Clinics of Work and the field of Work-Related Mental Health (WRMH).

Results  concepts such as weariness and the socialization of suffering are crucial for developing more effective forms of intervention, yet they are often overlooked in business environments.

Conclusion  this is a prime opportunity to inquire with companies about these aspects.

Mental Health; Work; Work Clinics; Organizations; Occupational Health

Resumo

Introdução  a insuficiência do apelo das empresas a medidas individualizadas e individualizantes, sem qualquer intervenção sobre a organização do trabalho, é pouco eficiente como forma de mitigação dos efeitos devastadores da pandemia de covid-19 sobre a saúde mental dos trabalhadores e da população em geral.

Objetivo  indicar medidas de outra natureza, sobretudo a serem tomadas pelas empresas e pautadas por uma concepção ampliada de clínica, pela ciência das dimensões psicossociais do processo saúde-doença e pela consideração da socialização do sofrimento nos espaços de trabalho.

Métodos  argumenta-se, a partir de revisão de literatura, sobre descobertas importantes das Clínicas do Trabalho e do campo da Saúde Mental Relacionada ao Trabalho (SMRT).

Resultados  recuperam-se noções relegadas nos ambientes empresariais frequentemente, como as de desgaste e socialização do sofrimento, cruciais para se pensarem formas de intervenção mais eficazes.

Conclusão  julga-se, enfim, que se trata de um momento oportuno para inquirir as empresas quanto a esses aspectos.

Saúde Mental; Trabalho; Clínicas do Trabalho; Organizações; Saúde do Trabalhador

Introduction

The serious effects of the COVID-19 pandemic on the mental health of both male and female workers and the general population have been highlighted. In its most recent and comprehensive report on the issue, the World Health Organization (WHO) brought together a series of investigations that demonstrated the upsurge in mental health before and after the outbreak of the pandemic, calling for organized and broad actions to promote health and prevention¹. Regarding the mental health, specifically, of those who work, systematic reviews can already be found - indicating, for example, that, for the most part, research has focused on the work of health professionals, which, however, can serve as a model for studies with other occupations, their specific challenges, and the role of managers at different levels²; or that the effects, of a different nature, of the pandemic on the mental health of employees at the beginning and at the end of its outbreak should be differentiated³. Although they are still ongoing, these investigations indicate that the forms of intervention against such harmful effects must undoubtedly involve dimensions that transcend individuals.

Aware of the seriousness of this scenario, companies at home and abroad were urged to act. Concerned about the billion-dollar losses resulting from work-related illnesses - which in Brazil are estimated at almost 5% of gross domestic product (GDP)⁴ - they began, as they say in the jargon of the area, to “invest in mental health”⁵. At the same time, initiatives such as the Global Pact have been reiterated, which since 2000 has been trying - albeit without much success so far - to get companies to commit to issues such as human rights, the environment, anti-corruption and health. Rede Brasil, the initiative’s representative in our country, announced the launch of the 2030 Agenda in May 2022, made up of various movements, each with its own specific focus, but whose overall aim is to engage organizations in taking concrete actions, achieving goals and making public commitments⁶. Among these movements is Mente em Foco (Mind in Focus), whose aim is to get signatory companies to comply with the Sustainable Development Goals (SDGs) on mental health. These initiatives and movements indicate that, after years of relegating the problem, as indicated by the United Nations (UN) report mentioned above¹ the mental health agenda has, in some way, ended up imposing itself on companies.

However, what we see is precisely the choice of individualized and individualizing measures, without any intervention in the organization of work - that is, in the definition of tasks, in the establishment of hierarchies, in the division of people, in the determination of responsibilities. Individualized because they operate only at the level of individuals; individualizing because, by operating in this way, they reduce problems arising from the organization of work to individual issues.

News articles in prestigious and important media outlets in the business sector provide this information. For example, an article in the newspaper Valor Econômico indicates that the actions taken by companies to deal with mental health problems include relaxation activities for employees, gym memberships, dietary advice, and psychological care⁵. In terms of company policies, the only measure mentioned is the cessation of after-hours communications - which is still awaiting legal regulation and depends solely on the goodwill of managers. More impressively, an article in Forbes magazine, a world leader in the sector, extols the benefits for employees of the Gympass platform, which offers gym services, studios, yoga, and audiovisual materials⁷. Even after acknowledging that the pandemic and the recent phenomenon of “Great Resignation” - an expression that refers to the high rates of voluntary resignation, especially in the US - have made us “collectively want to change our lives”, the article concludes, as if it had forgotten what it had said just before, that using the Gympass platform is a “smart and easy way” to deal with the problem⁷.

Among these individualized and individualizing measures, one of the most noteworthy is individual therapy via digital platforms. In Brazil, the growth of this phenomenon has been notable since 2020, when the National Agency of Supplementary Health, in technical note No. 6/2020⁸, made it compulsory for operators to offer telemedicine services. Since then, there has been an exponential growth in telecare startups. Despite becoming an important resource, especially during the periods when movement of people was most restricted during the pandemic, telecare soon became the object of primarily marketing interests. An article in Você S/A magazine, for example, seems to illustrate this well by unabashedly designating the field of mental health not only as a market but also as an “unprecedented window of opportunity [...]”⁹. It should be remembered that the tech giants had already been spending billions of dollars on initiatives in the health sector¹⁰, but they took a step towards the specific field of mental health: Meta, the company that controls Facebook, Instagram, and WhatsApp, among others, decided to invest in it¹¹.

In the light of the findings of psychological knowledge on the subject of work, the results of which are in line with the indications made by the studies on mental health mentioned above¹-³, it can be assumed that the measures taken by companies are insufficient, to say the least. However, these findings need to be revisited in order to clarify the reasons for this inadequacy. The time seems to be ripe for this task^b.

Murtola and Vallelly believe that the pandemic has “opened up the possibility of thinking about well-being in a radical way”, as it has “cemented the fact that well-being is a relational issue, not an individual one”¹³ (p. 2). It seems too much to say, but perhaps we can at least consider that this is a rare moment to effectively question companies about their mitigation tactics and strategies. In any case, if this is not done, they will naturally turn to the services of a booming market, which seems to lack concern for effective change and structural interventions.

In view of the problematization of such measures and considering the extraordinary opportunity to promote the discussion that follows, this article proposes to revisit fundamental developments in psychological knowledge focused on work, regarding the notions of clinic and health. Firstly, it recovers a thread of reflections that culminated in the creation of the so-called Clinics of Work, to show that the discoveries made by these clinics have been ignored, judging by the conception of the clinical device - called traditional liberal - to which companies seem to be accustomed. Next, we go back to the important reflections in the field of Work-Related Mental Health (WRMH) in order to point out the companies’ adherence to a discourse that conceives of illness as an individual biological phenomenon and health as a state of well-being - positions overcome by WRMH. Finally, it is suggested that the horizon of actions to be taken in the face of the catastrophic situation we are experiencing is the socialization of suffering, the royal road to transforming the conditions and organization of work.

“The ‘sickbed’ is the social context ”: unknown clinical problems

In order to identify the theoretical and methodological foundations on which the refined and expanded conception of the clinic nurtured, in general, by the Clinics of Work¹⁴ is based, a certain thread of reflections must be retraced. At its origin, we find the French psychopathology of work from the 1950s, which was urged to continue clinical practice in adverse situations.

In her meticulous study, Isabelle Billiard¹⁵ shows how the interventions and therapeutic conceptions of the pioneers in this field - Louis Le Guillant, Paul Sivadon, Claude Veil - are linked to the extremely adverse conditions under which psychiatric hospitals were forced to operate during the Second World War. It was in this context that discoveries emerged, such as the therapeutic importance of de-hospitalization, noted by Le Guillant at the La-Charité-sur-Loire hospital, or occupational therapy and collective referral spaces, spearheaded by François Tosquelles at the Saint-Alban hospital and which would serve as the foundation for Institutional Psychotherapy. The degree of adversity presented to these practitioners urged them to develop a clinic that was already very different from the traditional medical and liberal model.

Billiard shows that two important concepts emerged from these experiences. On the one hand, by investigating the pathologies found in certain trades, Sivadon and Veil set up what the author calls a “clinic of the subject”, in other words, a clinic of the problems faced by the subject when carrying out tasks. However, while Sivadon focused on the fragility of the worker in the face of situations of insecurity and conflict, Veil was able to combine the analysis of these aspects with an investigation into the organization of work and situations that are still very much current, such as unemployment, accidents at work and fear in the workplace. On the other hand, Le Guillant set up a “clinic of situations”, oriented towards finding the intrinsically pathogenic effects of certain working conditions. He delved into the material conditions of mental illness, pioneering discussions that are very contemporary today, such as the pathologies resulting from the intensification of work, the role of resentment and the importance of recognition.

Dominique Lhuillier takes up Billliard’s analysis, pointing out how the articulation of these two clinical conceptions is “heuristically fruitful”¹⁶ (p. 40) and how they have contributed to a central perspective of labor clinics: paying attention to both the manifestations of suffering and the ways of coping, resisting and responding to it. This is why this concept is in no way reduced to the investigation of disorders or pathological behavior. In short, it is a clinic in which “the ‘sickbed’ is the social context”¹⁶ (p. 25). Let’s remember that the modern notion of clinic, originally derived from the medical gesture of leaning over the patient’s bed, was founded on the emergence of a discourse on the sick based on the gaze¹⁷. The conceptions recovered above, therefore, subvert this traditional notion.

It was above all with the emergence of so-called French psychosociology in the 1960s that an explicit concern with refining the very notion of the clinic emerged. Among the authors of this strand are names such as Max Pagès, Guy Palmade, André Levy, Jean-Claude Rouchy, and Jacqueline Barus-Michel, gathered under the Association pour la Recherche et l’Intervention Psychossociologiques (ARIP), Eugène Enriquez, and Gerard Mendel. In works such as Lévy’s, we find formulations that attest to the definitive distancing of these authors from that conception of the traditional clinic. In fact, the clinic should be understood as the construction of “a research practice, on the other hand, directly involved in the processes of change thus undertaken, thus breaking with the principles of scientific positivism”¹⁸ (p. 20). In other words, the clinical démarche is that of a positioning both in relation to the other and in relation to knowledge, marked by deep implication and the progressive and incessant discovery of meanings.

This refined and expanded notion has proved to be key to the Clinics of Work. This is what Lhuillier attests to when he highlights the convergence, despite the field’s epistemological disagreements, around the idea that the clinic corresponds to a particular form of knowledge production in which there is “co-production of the understanding of the meaning of behaviors in a situation”¹⁹ (p. 182). This means that, from this perspective, one must abort not only any assumption of knowledge, but also any protocol. It’s not a question of producing a diagnosis and implementing a therapy designed to cure ailments. Rather, it is about promoting ways of involving subjects so that the relationships between them and with the institution or organization in which they work can be transformed. These ways are linked, on the one hand, to a demand - in other words, a desire for change or transformation on the part of these subjects - and, on the other, to the mobilization of devices capable of setting these subjects in motion - for example: group discussions, surveys, life stories, interviews, audiovisual resources that promote the exchange of experiences.

In this way, the thread of reflections that culminates in the Clinics of Work indicates a series of elaborations that underpin, expand and refine the meaning of clinic, making it fully operative in work situations. There has been almost a century of experience with these situations, which, on the one hand, demonstrate the limitations of the traditional liberal clinical device when faced with work problems and, on the other, the possibility of transformations in the conditions and organization of work. Experiences which, it seems, companies that adopt individual care as their central or only mental health policy are unaware of and don’t want to know about.

Contrary to what the massive commitment to this type of care indicates, the attempt to reverse the bleak post-pandemic mental health scenario requires the “participation of workers in the construction of procedures in the companies’ action plans and the transparency of actions”, factors that “could create practices to be expanded in the search for more horizontal and democratic relationships, which open up possibilities for a daily life with greater protection for workers’ health”²⁰ (p. 121). Such an expanded conception of the clinic is very much in line with these objectives.

At the same time, it would prevent the old and insidious functionalist and individualizing view of workers’ health, guided by the need to control the workforce and so well summarized by Sato and Bernardo²¹, from returning in this new “technological” guise. In fact, it’s not just a return, but, as Souza and Abagaro have shown, a real uberized mental health model, in which health workers appear “as supposed entrepreneurs who are partners of the platforms, or even a special type of consumer of the services of these platforms”, so that the result is “a health work process subordinated to technology (with a capitalist cognitive base) that enhances the accumulation of capital, on the one hand, and the precariousness of work, on the other”²² (p. 8). In this sense, in addition to the limitations pointed out above, the bet on the model in question by companies can contribute even more to the disfigurement of the morphology of health work in general. Hence the great importance of revisiting these clinical issues.

Occupational health as “the possibility of intervening in one’s own work”: relegated precepts

In addition to relying on this treatment model, whose limitations have been pointed out by those who have investigated suffering at work since the 1950s, we are witnessing the adoption of a concept of illness that goes back to classic occupational health. This is what sanitarian Asa Cristina Laurell called the “dominant paradigm of illness, which conceptualizes it as an individual biological phenomenon”²³ (p. 135). Let’s return, then, to another thread of reflection, which has led to the deconstruction of this paradigm in favor of building another that is consistent with investigations into suffering at work.

Against this paradigm, Laurell affirmed the historical and social nature of the health-disease process. This fact could be empirically verified through indicators such as life expectancy and nutritional conditions, as well as in the so-called pathological profiles (type and frequency of disease affecting a given group at a given time), which vary over time according to the degree of development, the social organization of each country and social class. This is why it was a process, both biological and social, of wear and reproduction. Conceived in these terms, this concept ruled out a binary understanding of health and disease, supported by a unicausal model of positivist extraction.

In this other theoretical horizon, two important and interrelated notions emerged: wear and tear and workload. The latter refers to what is required by the organization of work and the activity of those who work. The demands could be physical, chemical, biological or psychological. They combined and acted on workers, producing patterns of wear and tear - hence the close link between these and workloads. These patterns attested to what was seen as an actual or potential “loss of biopsychic capacity” in workers. In other words, it was something that prevented workers from adapting to their tasks and realizing their potential. It can be seen that the notion of wear and tear indicated a process that was different from the actual pathological process, because it was non-specific, dynamic and required other reproductive processes to be taken into account²⁴.

These notions proved to be fundamental to the construction of the WRMH field based on an understanding of the inseparability between the health-disease and work processes. As a result, it was possible to identify the changes needed to improve working conditions and health in the workplace. The crux of the conflict between capital and labor could thus be touched.

Edith Seligmann-Silva proposed taking up the notion of attrition but purifying it so as to transform it into an “integrating conceptual option”²⁵ (p. 78). Firstly, this proposal made it possible to understand the various levels of interaction: a) between environmental and psychosocial factors; b) between subjectivity and identity; and c) between the different spheres of social life in which power relations are developed. Secondly, it has made it possible to understand wear and tear on various levels: organic, as in the case of poisoning (by lead, mercury, toluene, styrene, etc.) and accidents that compromise the biochemical processes of the nervous system; functional, as in fatigue and various kinds of discomfort; and subjective, a level that includes the subject’s identity, their psychosomatic economy and the corrosion of their character²⁶. In other words, these two orders of gain show that the notion of wear and tear makes it possible, on the one hand, to produce informed questions about the aspects that act on the process of wear and tear and, on the other, to investigate the nature of wear and tear and the impairment of subjects’ mental health.

These are gains that manage to integrate the hegemonic notion of stress and, at the same time, overcome its limitations, which become even more evident in management discourse. As William Davies has shown, “the science of stress was of the utmost importance to managers concerned about the exhaustion of their workforces”, insofar as it enabled them to gain “rudimentary wisdom amidst a panoply of biopsychosocial complaints”²⁷ (p. 133). In other words, the concept of stress was easy to understand and, coming from physics and engineering, where it was taken as the force exerted on a solid body, causing tension, it was very similar to the mechanistic and functionalist conceptions that mark the field of management. Thus, despite the refinements that the concept has undergone, this area still takes it from the point of view highlighted by J. F. Chanlat: as an individual, abstract machine, subject to statistical normality²⁸.

In fact, even a more elaborate discourse such as that of the WHO still upholds the view that health is a state and not a process. Just remember that the organization still maintains the 1946 definition: “health is a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity”²⁹. Back in the 1980s, Christophe Dejours had already shown how abstract this definition is. Seeking to make it concrete and rectify it, the author stated that “health, for every man, woman, or child, is having the means to trace a personal and original path towards physical, psychological, and social well-being”³⁰ (p. 11). Based on the dejourian criticisms, Maeno and Paparelli state that the analysis of professional activities with a high prevalence of mental health problems reveals a submission of workers to the organization of work. For this reason, it could be said that “living health at work means having the possibility of intervening in one’s own work”³¹ (p. 148). Contrary, therefore, to the definition maintained by the WHO and adopted by business discourse, health consists of a process of struggle in which the human being plays the role of subject.

The damaging effects on body and mind linked to the COVID-19 pandemic make it even more necessary to conceptualize health-disease processes in the world of work. The vertiginous increase in work-related mental illnesses should make it clear that the nature of this phenomenon is due to social processes and has detrimentally progressive effects on subjectivity. However, a model that sees employees as machines subjected to overload cannot see these dimensions. Hence the individual solutions listed: therapy, gymnastics, relaxation techniques, Gympass services. That’s why illness is understood only as what hinders the functioning of the machine and health as the silent state of its gears in motion.

Socializing suffering at work: a necessary horizon

At the root of the corporate world’s more or less conscious adherence to such views of the clinic, health and illness is the assumption of the individual nature of suffering. In fact, there is a convergence between this adherence and the way in which workers end up dealing with it. This convergence turns suffering into a taboo, which, at best, is only touched upon in the private space of a therapy. Dejours pointed out how the issue of suffering was denied even by political and trade union organizations, which created a demand that was met by the new management discourse that emerged from the 1980s onwards: “where trade unions did not want to venture, bosses and managers formulated new conceptions and introduced new methods concerning subjectivity and the meaning of work: corporate culture, institutional design, organizational mobilization, etc. [...]”³² (p. 39). With the unemployment crisis that followed, on the other hand, denial of suffering began to occur in order not to lose one’s job, even in the face of awareness of the harm it caused³³.

Whoever decides to stop cosmetically pushing the mental health agenda in organizations should start by spreading efforts to socialize suffering at work. “It is a question of restoring what can be called the capacity of a voice to ‘move from inarticulate suffering to the elaboration of a common meaning’”³⁴ (p. 79). Since suffering cannot be accessed directly and is not even clear and distinct to the subjects themselves, a work of identification and naming is necessary, which must involve the collective sphere. It is in this sphere that they acquire political visibility and can be the driving force behind the transformation of work organization.

Such socialization implies, in turn, understanding that work is a field of struggle against suffering, which always emerges because there is an irreducible gap between the way work should be carried out (according to the planning usually done by managers) and the way it is actually carried out. Activity ergonomics, one of the fundamental disciplines of many labor clinics, has shown that what has become common sense since the rise of Taylorism - the separation between conception and execution - does not stand up to observation even in activities considered elementary, such as those that take place on assembly lines. The simplest gesture on a production conveyor belt requires a whole complex mental activity, which is overlooked by those dedicated to design, but thanks to which the work is carried out. For this reason, organizational functioning can only be guaranteed, “in its quality and quantity, when operators do not strictly observe the orders given to them.”³⁵ (p. 12). In other words, if the managers’ ideas were followed to the letter, the work wouldn’t happen. Thus, the ergonomics of activity has taught us that working is, in fact, overcoming prescriptions by mobilizing the knowledge of those who work.

In this way, socializing suffering also implies conveying the idea that it is not necessarily pathogenic. On the contrary, it can be the driving force behind mastery. It also implies distinguishing this structuring suffering from that which involves the rigidities of work organization. It is the latter that should be the subject of collective discussion. Otherwise, its silencing will be the reason for impotence, domination and alienation.

Conclusion

We need to take advantage of this moment in which the catastrophe has pushed companies to raise the profile of mental health at work to put into circulation all the discoveries that psychological knowledge about work has produced over almost a century. It is hoped that this circulation, to which this article aims to contribute, albeit very modestly, can at least question the measures they have taken and expose the agenda that has guided them. This paper has tried to show, by recovering a small part of the aforementioned list of discoveries, the insufficiency of adopting the old conceptions of clinical practice, health, and illness in the face of the enormous challenges that the pandemic, above all, has presented us with. They require the mobilization of a broader conception of the clinic, of the psychosocial dimensions of the health-disease process and of the socialization of suffering in workplaces.

References

• ¹ World Health Organization. World mental health report: Transforming mental health for all. Genebra: World Health Organization; 2022.
• ² Sigahi TFAC, Kawasaki BC, Bolis I, Morioka SN. A systematic review on the impacts of Covid-19 on work: contributions and a path forward from the perspectives of ergonomics and psychodynamics of work. Hum Factors Ergon Manuf. 2021 Jul;31(4):375-388. https://doi.org/10.1002/hfm.20889
  » https://doi.org/10.1002/hfm.20889
• ³ Hamouche S. COVID-19 and employees' mental health: stressors, moderators and agenda for organizational actions. Emerald Open Res. 2020;20:2-15. https://doi.org/10.35241/emeraldopenres.13550.1
  » https://doi.org/10.35241/emeraldopenres.13550.1
• ⁴ Bouças C. Transtorno mental gera perda de 4,7% do PIB. Valor Econômico. 9 mar 2023 [citado 31 mar 2023]. Disponível em: https://valor.globo.com/brasil/noticia/2023/03/09/transtorno-mental-gera-perda-de-47-do-pib.ghtml
  » https://valor.globo.com/brasil/noticia/2023/03/09/transtorno-mental-gera-perda-de-47-do-pib.ghtml
• ⁵ Pombo B. Empresas investem em saúde mental. Valor Econômico. 12 jan 2023 [citado 31 mar 2023]. Disponível em: https://valor.globo.com/legislacao/noticia/2023/01/12/empresas-investem-em-saude-mental.ghtml
  » https://valor.globo.com/legislacao/noticia/2023/01/12/empresas-investem-em-saude-mental.ghtml
• ⁶ Rozman G, Olivera G. Plataforma de monitoramento das empresas para a sustentabilidade. GVExecutivo; 2022 ago;21(3):19-23. https://doi.org/10.12660/gvexec.v21n3.2022.86834
  » https://doi.org/10.12660/gvexec.v21n3.2022.86834
• ⁷ Kelly J. Here's How gympass offers a smart, easy way for companies to improve the physical, mental and emotional wellbeing of their employees. Forbes. 23 out 2021 [citado 31 mar 2023]. Disponível em: https://www.forbes.com/sites/jackkelly/2021/10/23/heres-how-gympass-offers-a-smart-easy-way-for-companies-to-improve-the-physical-mental-and-emotional-wellbeing-of-their-employees/?sh=7faf272d3338
  » https://www.forbes.com/sites/jackkelly/2021/10/23/heres-how-gympass-offers-a-smart-easy-way-for-companies-to-improve-the-physical-mental-and-emotional-wellbeing-of-their-employees/?sh=7faf272d3338
• ⁸ Agência Nacional de Saúde Suplementar. Nota técnica nº 6/2020/DIRAD-DIDES/DIDES. Telemedina. Covid-19. Medida Judicial. Brasília, DF; 2020 [citado 31 mar 2023]. Disponível em: https://www.gov.br/ans/pt-br/arquivos/assuntos/coronavirus-covid-19/notas-tecnicas_covid-19/nota-tecnica-6-2020-dirad-dides-dides.pdf
  » https://www.gov.br/ans/pt-br/arquivos/assuntos/coronavirus-covid-19/notas-tecnicas_covid-19/nota-tecnica-6-2020-dirad-dides-dides.pdf
• ⁹ Lima J. Empreendedores apostam no mercado de saúde mental. Você S/A. 8 mar 2021 [citado 31 mar 2023]. Disponível em: https://vocesa.abril.com.br/empreendedorismo/empreendedores-apostam-no-mercado-de-saude-mental/
  » https://vocesa.abril.com.br/empreendedorismo/empreendedores-apostam-no-mercado-de-saude-mental/
• ¹⁰ Monterastelli A. Como a Google quer dominar o setor da saúde. Outra Saúde. 27 jun 2022 [citado 31 mar 2023]. Disponível em: https://outraspalavras.net/outrasaude/como-a-google-quer-dominar-o-setor-da-saude/
  » https://outraspalavras.net/outrasaude/como-a-google-quer-dominar-o-setor-da-saude/
• ¹¹ Wang C. As an Asian mental wellness pioneer, Singapore and Jakarta-based Ami seeks to change narratives about company well-being in the region: and investors see the benefits. Forbes 4 maio 2022 [citado 31 mar 2023]. Disponível em: https://www.forbes.com/sites/catherinewang/2022/05/04/meta-makes-first-asia-investment-with-mental-health-startups-3-million-seed-round/?sh=544be3c32145
  » https://www.forbes.com/sites/catherinewang/2022/05/04/meta-makes-first-asia-investment-with-mental-health-startups-3-million-seed-round/?sh=544be3c32145
• ¹² Brasil. Lei nº 14.831, de 27 de março de 2024. Diário Oficial da União [Internet]. 2024 mar. 28 [citado em 18 jul. 2024]; 1: 61.
• ¹³ Murtola A-M, Vallelly N. Who cares for wellbeing? Corporate wellness, social reproduction and the essential worker. Organization; 2022;30(3):135050842211316). https://doi.org/10.1177/13505084221131642
  » https://doi.org/10.1177/13505084221131642
• ¹⁴ Bendassolli PF, Soboll LA, editores. Clínicas do trabalho: novas perspectivas para compreensão do trabalho na atualidade. São Paulo: Atlas, 2011.
• ¹⁵ Billiard I. Santé mentale et travail: l'émergence de la psychopathologie du travail. Paris: La Dispute; 2001.
• ¹⁶ Lhuillier D. Filiações teóricas das clínicas do trabalho. In: Bendassolli PF, Soboll LAP, editores. Clínicas do trabalho novas perspectivas para compreensão do trabalho na atualidade. São Paulo: Atlas; 2011. p. 22-58.
• ¹⁷ Foucault M. Nascimento da clínica. Rio de Janeiro: Forense; 2004.
• ¹⁸ Lévy A. Ciências clínicas e organizações sociais. Belo Horizonte: Autêntica; 2001.
• ¹⁹ Lhuillier D. Cliniques du travail. Nouv Rev Psychosociol. 2006;1(1):179-193.
• ²⁰ Maeno M. Doenças ocupacionais relacionadas à pandemia de COVID-19: fatores de risco e prevenção. Basis TRT-2. 2021 mar; (25):108-121.
• ²¹ Sato L., Bernardo MH. Saúde mental e trabalho: os problemas que persistem. Cien Saude Colet; 2005 dez;10(4):869-78. https://doi.org/10.1590/S1413-81232005000400011
  » https://doi.org/10.1590/S1413-81232005000400011
• ²² Souza DO, Abagaro CP. A uberização do trabalho em saúde: expansão no contexto da pandemia de Covid-19. Trab Educ Saude. 2021;19(1):1-15. https://doi.org/10.1590/1981-7746-sol00328
  » https://doi.org/10.1590/1981-7746-sol00328
• ²³ Laurell AC. A saúde-doença como processo social. In: Nunes ED, editor. Medicina social: aspectos históricos e sociais. São Paulo: Global; 1983. p. 134-58.
• ²⁴ Laurell AC, Noriega M. Processo de produção e saúde: trabalho e desgaste operário. São Paulo: Hucitec; 1989.
• ²⁵ Seligmann-Silva E. Desgaste mental no trabalho dominado. Rio de Janeiro: Editora UFRJ, Cortez; 1994.
• ²⁶ Seligmann-Silva E. Trabalho e desgaste mental: o direito de ser dono de si mesmo. São Paulo: Cortez; 2011.
• ²⁷ Davies W. The happiness industry: how the government and the big business sold us well-being. Londres: Verso; 2015.
• ²⁸ Seligmann-Silva E. Trabalho e desgaste mental: o direito de ser dono de si mesmo. São Paulo: Cortez; 2011. p. 129.
• ²⁹ World Health Organization. Constitution of the World Health Organization. Genebra: World Health Organization; 2009.
• ³⁰ Dejours C. Por um novo conceito de saúde. Rev. Bras. Saúde Ocup. 1986;14(54):7-11.
• ³¹ Maeno M, Paparelli, R. O trabalho como ele é e a saúde mental do trabalhador. In: Silveira MA, Sznelwar LI, Kikuchi LS, Maeno M, editores. Inovação para desenvolvimento de organizações sustentáveis: trabalho, fatores psicossociais e ambiente saudável. Campinas: Centro de Tecnologia da Informação "Renato Archer"; 2013, p. 145-66.
• ³² Dejours C. A banalização da injustiça social. Rio de Janeiro: Editora FGV; 2007, p. 39.
• ³³ Ribeiro HP, Lacaz FAC, Clemente CA, Dutra, P. Entrevista: Herval Pina Ribeiro, Francisco Antonio de Castro Lacaz, Carlos Aparício Clemente e Pérsio Dutra falam sobre a história do DIESAT. Cad Psicol Soc Trab. 2002 dez;5:63-85.
• ³⁴ Périlleux T. O trabalho e os destinos políticos do sofrimento. In: Merlo ARC, Mendes AM, Moraes RD. O sujeito no trabalho: entre a saúde e a patologia. Curitiba: Juruá; 2013. p. 73-92.
• ³⁵ Daniellou F, Laville A, Teiger C. Ficção e realidade no trabalho operário. Rev. Bras. Saúde Ocup.; 1989;12(68):7-13.

• Data availability:
  The entire data set supporting the results of this study has been published in the article itself.
• Presentation at a scientific event:
  The author informs that the work has not been presented at a scientific event.
• b
  In fact, due not only to the serious scenario of the pandemic, described above, but also on the occasion of the recent sanction (after the approval of this essay) of Law No. 14.831, which determines the conditions for the certification of companies recognized as health promoters. Although the scope of this article prevents us from carrying out a detailed analysis of the individualizing assumptions of this law, especially regarding what it refers to as the “well-being of workers”, we believe that the following argument can at least guide the identification and problematization of these assumptions.

• Funding:
  The author declares that the work was not subsidized.

Edited by

• Editor-in-Chief:
  José Marçal Jackson Filho

Data availability

The entire data set supporting the results of this study has been published in the article itself.

Publication Dates

• Publication in this collection
  02 Dec 2024
• Date of issue
  2024

History

• Received
  01 July 2022
• Reviewed
  31 Mar 2023
• Accepted
  28 Apr 2023