Degradação da saúde mental da classe trabalhadora em tempos de acirramento da contrarreforma burguesa: vazios assistenciais e crise sanitária no contexto da pandemia de Covid-19

Abstract

This study addresses the issue of mental suffering among the working class within the context of a capitalist society and its contemporary expressions, which intensified during the COVID-19 pandemic. The study aimed to analyze the mental health deterioration of male and female workers as an expression of a contemporary social issue and the possible solutions to face it, using the reality of the state of Ceará as reference. We hypothesis that workers’ mental health deterioration represents a contemporary social problem and that there is a lack of support that violates the right to universal, full and timely access, jeopardizing the users’ health, a phenomenon that requires comprehensive understanding and assessment. For that reason, this paper adopts a social determination of health perspective based on critical social theory. Methodologically, we analyzed the exacerbation processes of exploitation and alienation, which are more complex and vicious in the new management methods of the post-Fordist industry, making the working class more susceptible to mental health issues amid evolving work dynamics in the flexible era. Thus, the study identifies the aggravation within the labor counter reform context combined with the nefarious effects of the pandemic, which leads to the exacerbation of work corrosion with even more harmful effects to the life quality of the working class, directly affecting the increase in mental health conditions related to work and the lack thereof. Our hypothesis is that the pandemic has enabled new precariousness and weakening strategies for work relationships, exacerbated by a general context of structural unemployment as an expression of the capital accumulation crisis. Thus, the pandemic has been viciously exploited by the capital as an opportunity to accelerate its offensive, justifying and deepening unemployment, insecurity, precariousness and flexibility, while framing exposure to risk as a solution to an economic crisis reduced to a health crisis. In order to meet the proposed objectives, we combined documentary and empirical research of a quantitative-qualitative nature, focusing on the Health Department of the State of Ceará. Documentary research and a focus group with the CEREST/CE technical team were conducted. Quantitative research was also part of the methodological procedures given the need to analyze epidemiological and statistical data that characterize the current scenario of the world of work in order to unravel the interconnections of the mental health and work dichotomy. We conclude that, in face of the impossibility of overcoming the mental health deterioration of the working class within the capitalist order, precisely due to the fact that it characterizes the contemporary expression of the social issue permeated by the inherent contradiction between capital and work, the protection of work results in the correlation of social fight and forces, requiring strong governmental intervention in order to guarantee the implementation of public policies capable of responding to this public health and social demand, especially in the aim of overcoming the challenge of the insipient assistance work and underreporting. We found that the setbacks in workers’ physical and mental health under the Bolsonaro government, especially during the pandemic, hindered initiatives by state and municipal governments to implement the National Worker Health Policy, as per Ordinance 1.823/2012. Despite this challenging context, we identified that Ceará has made strides in formalizing public policies for workers with mental health disorders related to work, albeit in an embryonic stage, indicating recognition of this social issue but not yet constituting state policy.