DESCRIPTORS: Mental Health Services. Health Manpower. Health Management. Organizational Case Studies

ABSTRACT OBJECTIVE: To analyze work organization in psychosocial healthcare services from the logic of the service management fi eld. METHODS: Organizational analysis was performed, using a case study in a psychosocial healthcare service located in the city of São Paulo, Southeastern Brazil, between 2006 and 2007. A total of fi ve sources of information were analyzed: Ministry of Health documents, research reports made in the service studied, service records, interviews with healthcare workers and managers and simple observation. Interviews dealt with objectives, results and assessment of work process. Each source was treated differently, according to its purpose. A subsequent dialogue about the results obtained aimed to make a set of observations on which the case study was founded. RESULTS: The service proposes to deliver a very intangible result, which views the user in their social context. The intended change in the user's conditions was described as "the person living better". Such condition is diffi cult to be defi ned and understood in terms of the details and limits of this change, thus hindering measurement of results. In addition, the work process involves activities which are not routinary, not predictable and sometimes simultaneous, so that the team fi nds it diffi cult to recognize and legitimize efforts made to perform work, a fact described as "work invisibility" by workers. CONCLUSIONS: The assessment process was found to be a complex aspect of this intangibility, associated with inadequacy and insuffi ciency of the municipal health system's management structure to include a service of this nature. Results enabled better understanding of a fi eld of work where workers' and users' subjectivity is inherent in the service management process