Studies of MHWs, (social workers, social auxiliary workers, trauma counsellors, and telephone counsellors), who work with trauma and stress, often focus on pathological symptoms and on the need to develop psycho-education programmes (Figley, 2002; Johnson & Hunter, 1997; Mac Ritchie & Leibowitz, 2010; Mikulincer, 1994; Stiles, 2002). A gap was identified how MHWs, who continuously intervene with traumatised children, cope with the stressors associated with their work. The purpose of this research was to explore the coping strategies of Mental Health Workers (MHWs) exposed to Secondary Trauma (ST)as a result of having to deal day to day with children (younger than 18) who have experienced trauma, including sexual, physical and emotional abuse, as well as the witness of violence. The MHWs’ coping responses were investigated using a qualitative case study approach. The investigation showed how MHWs constructed their realities by examining their coping strategies and the individual meanings they assigned to these. A convenience sample, based on the availability of participants, was selected. Nine women and one man, ranging in age from 26 to 57 years, employed at Childline Gauteng, participated in the research. The Mmogo-Method®, a projective visual research technique, explored the MHWs’ coping experiences through qualitative data collection methods. Visual and textual data were gathered and analysed thematically. It was found that the MHWs at Childline Gauteng displayed two main coping styles, namely intrapersonal and relational coping strategies. In the face of their daily stressors, MHWs managed to cope successfully by using strategies that are embedded in their daily activities. Their ability to find alternative ways to cope, despite continuous exposure to children’s trauma, allowed the MHWs to fulfil their work obligations. Their intrapersonal coping strategies reflected an ability to draw on their inner resources. Being aware of their environment and how it affects them, MHWs were able to regulate themselves and their environments by adopting positive attitudes. These attitudes, and the MHWs’ dispositions, positively affected their outlook on life. Moreover, MHWs maintained a healthy distance from their stressful environment by means of meaningful disengagement. Meaningful disengagement was fundamental to creating solitude as a coping strategy. Personal and professional boundaries, self-care and being able to draw on spirituality were further coping resources. MHWs’ discussions about finding meaning in their work revealed that they would not be able to do their work if they did not experience it as spiritually significant. Drawing on external resources, relational coping strategies included supportive relationships with family, friends and colleagues. Reciprocal unconditional acceptance significantly contributed to coping because it was important for MHWs to experience family and friends' attitudes as supportive and non-judgemental. MHWs encountered an organisational culture of care in the form of freedom to interact with colleagues and managers and sharing experiences. This interaction contributed to successful coping because MHWs felt comfort in the knowledge that they were not alone when dealing with children's trauma. This interaction facilitated coping because MHWs were able to interface successfully with their environment, even in difficult circumstances. In conclusion, the MHWs provided nuanced descriptions of the ways in which they experienced coping strategies. They coped with the demands of their profession by using internal and external resources, including intrapersonal and relational coping. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

In my diploma thesis I would like to discuss palliative (hospice care) in the Czech Republic, development of services and legislation associated with it. Further forms of hospice care services for families and clients. In the next chapter I would like to mention the risks and problems that the employees of hospice care in their work meet. Of this chapter, I followed a question of psychic health workers by employers and other options to avoid the risk factors associated with the exercise of this profession. In the research part, I would like to do qualitative research on the selected device, focusing on problems that are often faced by employees and that the support of the leadership sufficient.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

Studies of MHWs, (social workers, social auxiliary workers, trauma counsellors, and telephone counsellors), who work with trauma and stress, often focus on pathological symptoms and on the need to develop psycho-education programmes (Figley, 2002; Johnson & Hunter, 1997; Mac Ritchie & Leibowitz, 2010; Mikulincer, 1994; Stiles, 2002). A gap was identified how MHWs, who continuously intervene with traumatised children, cope with the stressors associated with their work. The purpose of this research was to explore the coping strategies of Mental Health Workers (MHWs) exposed to Secondary Trauma (ST)as a result of having to deal day to day with children (younger than 18) who have experienced trauma, including sexual, physical and emotional abuse, as well as the witness of violence. The MHWs’ coping responses were investigated using a qualitative case study approach. The investigation showed how MHWs constructed their realities by examining their coping strategies and the individual meanings they assigned to these. A convenience sample, based on the availability of participants, was selected. Nine women and one man, ranging in age from 26 to 57 years, employed at Childline Gauteng, participated in the research. The Mmogo-Method®, a projective visual research technique, explored the MHWs’ coping experiences through qualitative data collection methods. Visual and textual data were gathered and analysed thematically. It was found that the MHWs at Childline Gauteng displayed two main coping styles, namely intrapersonal and relational coping strategies. In the face of their daily stressors, MHWs managed to cope successfully by using strategies that are embedded in their daily activities. Their ability to find alternative ways to cope, despite continuous exposure to children’s trauma, allowed the MHWs to fulfil their work obligations. Their intrapersonal coping strategies reflected an ability to draw on their inner resources. Being aware of their environment and how it affects them, MHWs were able to regulate themselves and their environments by adopting positive attitudes. These attitudes, and the MHWs’ dispositions, positively affected their outlook on life. Moreover, MHWs maintained a healthy distance from their stressful environment by means of meaningful disengagement. Meaningful disengagement was fundamental to creating solitude as a coping strategy. Personal and professional boundaries, self-care and being able to draw on spirituality were further coping resources. MHWs’ discussions about finding meaning in their work revealed that they would not be able to do their work if they did not experience it as spiritually significant. Drawing on external resources, relational coping strategies included supportive relationships with family, friends and colleagues. Reciprocal unconditional acceptance significantly contributed to coping because it was important for MHWs to experience family and friends' attitudes as supportive and non-judgemental. MHWs encountered an organisational culture of care in the form of freedom to interact with colleagues and managers and sharing experiences. This interaction contributed to successful coping because MHWs felt comfort in the knowledge that they were not alone when dealing with children's trauma. This interaction facilitated coping because MHWs were able to interface successfully with their environment, even in difficult circumstances. In conclusion, the MHWs provided nuanced descriptions of the ways in which they experienced coping strategies. They coped with the demands of their profession by using internal and external resources, including intrapersonal and relational coping. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

Content removed due to copyright restrictions: Paper titled, "Practitioner characteristics with comparison of counselling and psychotherapy practices between New Zealand and Singapore mental health practitioners" was presented and published in the proceedings of The Inaugural International Asian Health Conference, at the University of Auckland, 4-5 November 2004. 2. Workshop cum paper titled, " A modified cognitive behavioural therapy model for working with Chinese people" was also presented and published in the above Conference. 3. Abstract on paper titled, "Integrating homework assignments based on culture: Working with Chinese patients" was accepted in April 2006 for publication in the Cognitive and Behavioral Practice. 4. Paper titled, "Cultural considerations in using cognitive behaviour therapy with Chinese people: A case study of an elderly Chinese woman with generalised anxiety disorder", was published in November 2006 in the New Zealand Journal oj Counselling, Volume 35(3), 1 53- 1 62, and presented at the 29th National Conference of the Australian Association for Cognitive Behaviour Therapy, 1 8- 20 October 2006, under the title "Cultural considerations for Chinese people: Implications for CBT". 5. Abstract on paper titled, "Cognitive behaviour therapy in New Zealand and S ingapore : From a doctoral study and personal experience" was presented and published (in a book of abstracts) at the 1 st Asian Cognitive Behaviour Therapy (CBT) Conference: Evidence-based Assessment, Theory and Treatment, at The Chinese University of Hong Kong, 28-30 May 2006. 6. Paper titled, "CounsellinglPsychotherapy with Chinese Singaporean clients" was published in 2006 in the Asian Journal oj Counselling, Volume 1 3(2), 27 1 -293 . / This study compared the characteristics, self-reported practices and experiential skills of mental health practitioners (MHPs) in New Zealand and Singapore with the aim of benefiting both nations in managing the mentally ill. A mixed-research design was used consisting of a mail questionnaire survey and a structured interview. For each country, mail questionnaires were sent to 300 MHPs, namely, counsellors, psychiatrists, psychologists, psychotherapists, and social workers, while structured interviews were held with 12 MHPs. Potential participants were drawn from available electronic or printed publications on counselling and psychotherapy services in both countries. Those drawn from individual listings of MHPs were systematically sampled, whereas those drawn from organisational listings of MHPs were sampled by way of estimation. Despite the relatively low response rates of 20% to 27% from the participants of the mail questionnaire, the major findings were supported and augmented by those from the structured interviews in the combined analysis of results. Results were categorised into personal, professional and practice characteristics of MHPs. Personal characteristics included demographic characteristics. Professional characteristics included training characteristics, primary job affiliation and use of Western therapy models and interventions. Practice characteristics were sub-divided into five categories: practice setting; diagnostic system and assessment procedures; client and caseload; gender/ethnic match; and experiential skills. Similarities in personal and demographic characteristics between MHPs of both New Zealand and Singapore were found with respect to gender, ethnicity, and language ability. Differences in these characteristics were found with respect to age range and religious affiliation. Similarities in professional characteristics between MHPs of both countries were found with respect to country of therapy training, qualification in therapy, number of years of supervised training received, and use of Western therapy models and interventions. Differences in these characteristics were found with respect to primary job affiliation, availability of clinical psychology programmes, years of experience in therapy, and registration of practice. Similarities in practice characteristics between MHPs of both countries were found with respect to relevance of therapy models, focus of practice, diagnostic system and use of assessment procedures, clients seen, clients' presenting problems, and gender/ethnic match. Differences in these characteristics were found with respect to preferences of therapy models, and average number of sessions per client. Similarities in experiential skills between MHPs of both countries were found with respect to handling of self-disclosure, religious or spiritual issues, and traditional healers. Implications for Chinese clients and cognitive behaviour therapy were discussed, as well as limitations of the study.

Content removed due to copyright restrictions: Paper titled, "Practitioner characteristics with comparison of counselling and psychotherapy practices between New Zealand and Singapore mental health practitioners" was presented and published in the proceedings of The Inaugural International Asian Health Conference, at the University of Auckland, 4-5 November 2004. 2. Workshop cum paper titled, " A modified cognitive behavioural therapy model for working with Chinese people" was also presented and published in the above Conference. 3. Abstract on paper titled, "Integrating homework assignments based on culture: Working with Chinese patients" was accepted in April 2006 for publication in the Cognitive and Behavioral Practice. 4. Paper titled, "Cultural considerations in using cognitive behaviour therapy with Chinese people: A case study of an elderly Chinese woman with generalised anxiety disorder", was published in November 2006 in the New Zealand Journal oj Counselling, Volume 35(3), 1 53- 1 62, and presented at the 29th National Conference of the Australian Association for Cognitive Behaviour Therapy, 1 8- 20 October 2006, under the title "Cultural considerations for Chinese people: Implications for CBT". 5. Abstract on paper titled, "Cognitive behaviour therapy in New Zealand and S ingapore : From a doctoral study and personal experience" was presented and published (in a book of abstracts) at the 1 st Asian Cognitive Behaviour Therapy (CBT) Conference: Evidence-based Assessment, Theory and Treatment, at The Chinese University of Hong Kong, 28-30 May 2006. 6. Paper titled, "CounsellinglPsychotherapy with Chinese Singaporean clients" was published in 2006 in the Asian Journal oj Counselling, Volume 1 3(2), 27 1 -293 . / This study compared the characteristics, self-reported practices and experiential skills of mental health practitioners (MHPs) in New Zealand and Singapore with the aim of benefiting both nations in managing the mentally ill. A mixed-research design was used consisting of a mail questionnaire survey and a structured interview. For each country, mail questionnaires were sent to 300 MHPs, namely, counsellors, psychiatrists, psychologists, psychotherapists, and social workers, while structured interviews were held with 12 MHPs. Potential participants were drawn from available electronic or printed publications on counselling and psychotherapy services in both countries. Those drawn from individual listings of MHPs were systematically sampled, whereas those drawn from organisational listings of MHPs were sampled by way of estimation. Despite the relatively low response rates of 20% to 27% from the participants of the mail questionnaire, the major findings were supported and augmented by those from the structured interviews in the combined analysis of results. Results were categorised into personal, professional and practice characteristics of MHPs. Personal characteristics included demographic characteristics. Professional characteristics included training characteristics, primary job affiliation and use of Western therapy models and interventions. Practice characteristics were sub-divided into five categories: practice setting; diagnostic system and assessment procedures; client and caseload; gender/ethnic match; and experiential skills. Similarities in personal and demographic characteristics between MHPs of both New Zealand and Singapore were found with respect to gender, ethnicity, and language ability. Differences in these characteristics were found with respect to age range and religious affiliation. Similarities in professional characteristics between MHPs of both countries were found with respect to country of therapy training, qualification in therapy, number of years of supervised training received, and use of Western therapy models and interventions. Differences in these characteristics were found with respect to primary job affiliation, availability of clinical psychology programmes, years of experience in therapy, and registration of practice. Similarities in practice characteristics between MHPs of both countries were found with respect to relevance of therapy models, focus of practice, diagnostic system and use of assessment procedures, clients seen, clients' presenting problems, and gender/ethnic match. Differences in these characteristics were found with respect to preferences of therapy models, and average number of sessions per client. Similarities in experiential skills between MHPs of both countries were found with respect to handling of self-disclosure, religious or spiritual issues, and traditional healers. Implications for Chinese clients and cognitive behaviour therapy were discussed, as well as limitations of the study.

The exploratory study aims to explore mental health representations in workers of two specialized institutions, through qualitative methodology. A total of ten members of two specialized institutions were selected, five from each, who comprise the interdisciplinary team in the area: A psychiatrist, a psychologist, a nurse, a nursing technician and a social worker. A semi-structured interview was developed to access the speech of the workers. Results show the representational world of the workers, their general conceptions about mental health, the factors that promote or interfere with it, as well as the reactions that a person that suffers mental illness generates, as well as expectations of improvement. / El presente estudio busca explorar las representaciones de la salud mental en los trabajadores de dos instituciones especializadas. Se seleccionó un total de diez participantes, cinco por cada institución, representantes de los trabajadores que conforman el equipo interdisciplinario del área: un psiquiatra, una psicóloga, una enfermera, una técnica de enfermería y una asistenta social. Para acceder a la narración y al discurso de los participantes, se aplicó una entrevista semiestructurada. Los resultados dan cuenta del mundo representacional de los trabajadores, exponiendo desde lo subjetivo, sus concepciones generales en torno a la salud mental, los factores que favorecen o interfieren en la misma, las reacciones que genera una persona que sufre una enfermedad mental y las expectativas de mejoría.

Made available in DSpace on 2017-07-21T14:42:36Z (GMT). No. of bitstreams: 1 Viviane Matoski.pdf: 2349880 bytes, checksum: b1e9d7e6c140b039014e6a036b83eb8b (MD5) Previous issue date: 2015-10-02 / This study analyzes the perceptions of workers, users, and their families on the Psychosocial Attention Centers (CAPS) of Ponta Grossa. We present the services offered, the actions carried out in these spaces, the expectations of CAPS users, the working conditions of the professionals (work regulations, workload hours, organizational environment, and qualification), and the influence of these factors on the quality of actions and on the daily work routine. Throughout this research, we had access to the dossier “Ponta Grossa – Saúde Mental”, from Associação de Apoio aos Portadores de Distúrbios de Ordem Mental (attachment B), forwarded to the Department of Public Prosecution of Paraná in March 2014. The dossier requires the compliance with the National Politics of Mental Health, showing that the components of the city's Psychosocial Attention Network (RAPS) are not in accordance with what is legally recommended. Even that the information from the dossier demonstrate the precariousness of the psychosocial attention network in Ponta Grossa, it is relevant to know the contributions that CAPS are carrying out in the lives of the supported population, according to the opinions of workers, users, and their families. This is an exploratory study with qualitative approach, bibliographical research, and documentary research. The following procedures were used for the collection of data: interviews, questionnaires, and observation; a methodological triangulation that assisted the understanding and analysis of our data. The research universe are the three CAPS of Ponta Grossa: CAPSad - alcohol and drugs, CAPSi - children, and CAPS II - mental disorder. As sample, we selected subjects amongst the ones that attend CAPS, their families, and professionals from the assistance teams. Interviews with the Management of Mental Health of Ponta Grossa and with CAPS coordinators have also been carried out. Two questionnaires have been applied to the users, two to their families and one for the workers of the three CAPS. This work is divided in three chapters. The first one explains the research's methodological path, a qualitative, descriptive, exploratory study using triangulation methods, what allowed the contextualization of the subject. In chapter 2, historical aspects on the Brazilian Psychiatric Reform's route are discussed, and the conception of health services network are analyzed, emphasizing the Psychosocial Attention Network and the Psychosocial Attention Centers. The third chapter contextualizes the Psychosocial Attention Centers of Ponta Grossa (for understanding of its administrative reality and diagnosis of the physical and structural conditions of the establishments). It also presents the profile of CAPS's workers and the results of the questionnaires applied to the research subjects. / O estudo analisa as percepções dos trabalhadores, usuários e seus familiares sobre os Centros de Atenção Psicossocial (CAPS) de Ponta Grossa. São apresentados os serviços ofertados, as ações realizadas nesses espaços, as expectativas dos usuários dos CAPS, as condições de trabalho dos profissionais - regime de trabalho, carga horária, ambiente organizacional e capacitação -, e a influência desses fatores na qualidade das ações e no cotidiano do trabalho. Ao longo desta pesquisa, teve-se acesso ao Dossiê “Ponta Grossa – Saúde Mental”, da Associação de Apoio aos Portadores de Distúrbios de Ordem Mental (Anexo B), encaminhado ao Ministério Público do Paraná em março de 2014. O dossiê solicita o cumprimento da Política Nacional de Saúde Mental, evidenciando que os componentes da Rede de Atenção Psicossocial (RAPS) do município não estão de acordo com o preconizado legalmente. Mesmo com as informações do dossiê que demonstram a precariedade da rede de atenção psicossocial em Ponta Grossa, entende-se relevante conhecer as contribuições que os CAPS estão realizando na vida da população atendida, conforme o olhar dos trabalhadores, usuários e familiares. Trata-se de um estudo exploratório com abordagem mista, qualitativa e quantitativa, pesquisa bibliográfica e documental. Para a realização da coleta de dados, são utilizados os seguintes procedimentos: entrevistas, questionários e observação, uma triangulação metodológica que auxiliou na compreensão e análise dos dados. O universo de pesquisa é os três CAPS de Ponta Grossa: CAPSad – álcool e drogas, o CAPSi – infantil e o CAPS II – TM – transtorno mental. Como amostra, foram selecionados sujeitos dentre os que frequentam os CAPS, seus familiares e os profissionais que compõem as equipes de atendimento. Foram realizadas, também, entrevistas com a Gerência de Saúde Mental de Ponta Grossa e com os coordenadores dos CAPS. Foram aplicados dois questionários aos usuários, dois aos familiares e um para os trabalhadores dos três CAPS. O trabalho está estruturado em três capítulos. O primeiro expõe o percurso metodológico da pesquisa, um estudo misto, com ênfase no qualitativo, pois trabalha-se com o discurso dos sujeitos participantes da pesquisa, sob a forma de estudo exploratório descritivo e com a triangulação de métodos, o que permitiu a contextualização do tema. No segundo capítulo, são relatados aspectos históricos sobre o percurso da Reforma Psiquiátrica Brasileira e se analisa a concepção de rede de serviços de saúde, com ênfase para a Rede de Atenção Psicossocial (as RAPS) e os Centros de Atenção Psicossocial. O terceiro capítulo contextualiza os Centros de Atenção Psicossocial de Ponta Grossa - para conhecimento da realidade administrativa e o diagnóstico das condições físico-estruturais dos estabelecimentos -, apresenta o perfil dos trabalhadores dos CAPS e os resultados dos questionários aplicados aos sujeitos da pesquisa.

Cette thèse vise à comprendre la dynamique du travail effectué par des professionnels de la santé mentale dans un hôpital psychiatrique public de Rio Grande do Sul, Hospital Psiquiátrico São Pedro (HPSP), et ses implications par rapport à la douleur et le plaisir. Les objectifs spécifiques sont: d'analyser l'organisation du travail, la détermination des relations de douleur et de plaisir, et connaître les stratégies de défense collective et de la santé, produites par ces travailleurs. La contribution théorique et méthodologique sont la psychodynamique du travail, de Christophe Dejours, appliquée strictu sensu, dans ses stades de développement. Nous avons utilisé les auteurs cités par leur liaison avec les thèmes: le travail: Marx, Dejours, Nardi, Lancman et Pitta, la folie et la santé mentale: Amarante, Magnolia Mendes, hôpital psychiatrique: Foucault et Dias, le service public: Rollo, Antunes, Castel, entre autres. Le sondage a une approche qualitative, qui est conforme au désir de comprendre les implications des travaux d'une institution marquée par la folie et la sphère publique par rapport à la subjectivité de leurs employés. Les données ont été recueillies au moyen de pré-recherche et des réunions avec le groupe des travailleurs, formé par des professionnels travaillant dans des unités d'hospitalisation pour malades aigus, dont le profil évolue pour les usagers de drogues, plus précisément le Crack. Il a été estimé que ces travailleurs sont dans un espace «entre», c'est à dire dans un espace de transition, qui aura des implications dans le processus de travail et de santé. Il a été constaté qu'ils utilisent des stratégies collectives de défense, comme l'éloignement, le durcissement et les plaintes et les stratégies collectives de la santé, exprimées à travers le commerce et l'aide, “l'oxygénation” et de changements possibles. Ces stratégies, cependant, sont en fait très conservatrices, n'ont pas changé la façon dont le travail est organisé. D'autre part, ces strategies aident à minimiser la douleur et d'obtenir un certain plaisir. L'étude constate l'existence de «chaînes», qui aggravent la souffrance au travail: le poids de la folie, l´ingérence politique, l´appauvrissement des ressources, les conditions et l´organisation du travail, où la précarité des liens relationnels avec les collègues est identifiée comme la plus grande charge. Un autre aspect souligné dans la recherche est le fait que les politiques publiques pour l'employé n'atteint pas les besoins internes, agissent pour surveiller les institutions. Les résultats ont montré l'importance de la construction d'un espace de discussion légitime dans l'hôpital São Pedro, qui permet de provoquer la force collective du groupe. Ainsi, il est possible de promouvoir la reconnaissance et la construction d'un sens pour le travail, fournissant plus de plaisir pour les travailleurs et pour donner la santé à ceux qui travaillent avec la santé. / Esta dissertação busca compreender a dinâmica do trabalho realizado por profissionais de saúde mental, de um hospital psiquiátrico público do Estado do Rio Grande do Sul, Hospital Psiquiátrico São Pedro,(HPSP), e suas implicações em relação ao sofrimento e ao prazer. Os objetivos específicos são: analisar a organização do trabalho, identificar a relação de sofrimento e prazer; e, conhecer as estratégias coletivas de defesa e de saúde, produzidas por estes trabalhadores. O aporte teórico metodológico utilizado foi a Psicodinâmica do Trabalho, de Christophe Dejours, aplicado de forma strictu sensu, em suas etapas de desenvolvimento. Para dialogar com esse referencial, recorreu-se a autores vinculados à temática do trabalho: como Marx, Dejours,Nardi, Lancman, e Pitta; loucura e saúde mental, Amarante, Magnólia Mendes; hospital psiquiátrico, como Foucaut e Dias; serviço público, Rollo, Antunes, Castel, dentre outros. A pesquisa possui abordagem qualitativa, o que é coerente com à intenção de entender as implicações do processo de trabalho em uma instituição, marcada pela loucura e pela esfera pública, em relação à subjetividade dos seus trabalhadores. Os dados foram obtidos através da pré-pesquisa e dos encontros realizados com o grupo de trabalhadores, formado por profissionais que atuam em unidades de internação de pacientes agudos, cujo perfil está se modificando para usuários de drogas, mais especificamente, de crack. Percebe-se que esses trabalhadores se encontram em um espaço do “entre”, ou seja, em um espaço de transição, que vai trazer implicações no processo de trabalho e de saúde. Constatou-se que eles utilizam estratégias coletivas de defesa, tais como: afastamento, endurecimento e reclamação; e estratégias coletivas de saúde, manifestadas através de trocas e ajuda, oxigenação e mudanças possíveis. Essas estratégias, no entanto, operam de forma conservadora, pois não alteram o modo pelo qual o trabalho está organizado. Permitem, por outro lado, minimizar o sofrimento e obter algum prazer. O estudo constata a existência de “grilhões” que exacerbam o sofrimento no trabalho: o peso da loucura, os atravessamentos políticos, o sucateamento dos recursos, as condições e a forma de organização do trabalho, em que a precariedade dos vínculos relacionais com os colegas é apontado como a maior carga. Outro aspecto ressaltado na pesquisa é o fato de que as políticas públicas existentes, voltadas ao trabalhador, não dão conta, na prática, da demanda interna, pois são ações que atuam, em sua maioria, no sentido de fiscalizar as instituições. Fica evidenciada a importância de se construir, no Hospital Psiquiátrico São Pedro, um espaço de discussão legítimo, que possibilite instigar a força coletiva do grupo. Assim, acredita-se ser possível fomentar o reconhecimento e a construção de um significado para o trabalho que proporcione mais prazer aos trabalhadores e que viabilize saúde a quem trata da saúde. / This essay searches for the understanding of the dynamics of the work made by mental health professionals of one psychiatric public hospital in the state of Rio Grande do Sul named Hospital Psiquiátrico São Pedro (HPSP) and its implications related to suffering and pleasure. The specific objectives are: to analyze the organization of the work; to identify the relation between suffering and pleasure and to know common strategies of defense and health produced by these workers. The theoretical-methodological subsidy used was Christopher Dejours’ Psychodynamics at Work applied in a strictu sensu pattern during its development stage. To work with such reference we looked for authors linked to the theme work such as Marx, Dejours, Nardi, Lancman and Pitta; madness and mental health, Amarante, Magnólia Mendes; psychiatric hospital, such as Foucault and Dias: public service, Rollo, Antunes, Castel, among others. The research is qualitative-based which is coherent to the intention of understanding the implications of the working process inside an institution surrounded by insanity and by the public domain in relation to the subjectivity of its employees. Data were obtained through a beforehand research and from the meetings held with the group of workers composed by the professionals who act in units of the asylum with seriously insane patients whose profile has changed to drug addicts, more specifically, crack. We came to the conclusion that these workers are found in a space “in between”, that is, in a transition space which will bring implications in the labor and health process. We also noticed that they use common health defense strategies manifested through the exchanges and help, oxygenation and possible changes. But these strategies work in a conservative model because they don’t alter the way the work is organized in itself. They allow, on the other hand, to minimize the suffering and to get some kind of pleasure. The study suggests the existence of mental links or mental chains which increase the suffering at work: the burden of madness, the political obstructions, the resources defraying, the conditions and the organization of the work where the poor relationship entailment among the workmates is appointed as the biggest burden. Another point to be considered in the research is the fact that the existing public politics made for the workers are not sufficient in practice to fulfill the internal demand due to the fact that they are actions that happen, in its majority, to control the institution. It is made clear the importance of making at Hospital Psiquiátrico São Pedro a real discussion scene that will promote the investigation of the common strength of such group. Therefore, we believe that it is possible to foment the acknowledgement and the making of a meaning to work that will bring pleasure for the employees and promote health to the ones that treat it.