title: Repercussions of violence on the mental health of workers of the Family Health Program.
abstract: OBJECTIVE
  To describe forms of external and indirect violence that affect the mental health of workers of the Programa Saúde da Família (Family Health Program), as well as the strategies developed by these workers to enable their work and to be psychologically protected.
  
  
  METHODS
  Qualitative study on the Programa Saúde da Família work process, performed in the cities of São Paulo, Ribeirão Preto and Embu (Southeastern Brazil) in 2005. Theoretical approach of psychodynamics of work, which proposes the formation of reflection groups with workers, was employed. Subjective aspects of work, situations of psychological suffering and strategies used by workers to deal with suffering and continue to work were sought to be identified.
  
  
  RESULTS
  The Program's work organization exposed workers to the following: situations of violence, invisible at times; feeling of impotence in the face of precarious situations; lack of acknowledgement of efforts made; lack of borders between professional and personal aspects; intense experiences of social and domestic violence; fear of risk of exposure; feeling of moral and physical integrity being threatened; and fear of reprisal. Situations of psychological suffering resulting from violence in the workplace were observed. These became more intense in the Programa Saúde da Família due to regular contact with situations of violence that cause fear and a feeling of vulnerability.
  
  
  CONCLUSIONS
  Psychological repercussions caused by violence in the workplace, not always expressed in the form of psychological disorders, were observed in situations of intense suffering. Workers develop strategies to minimize suffering, protect themselves psychologically and continue to work; and seek to create solidarity and protection networks with the population, aiming to reduce vulnerability. With the experience gained, they learn to detect high-risk situations, avoiding those they believe to be threatening.
authors.affiliation: Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. lancman@usp.br
authors.forename: Selma
authors.initials: S
authors.lastname: Lancman
authors.forename: Maria Isabel Garcez
authors.initials: MI
authors.lastname: Ghirardi
authors.forename: Eliane Dias de
authors.initials: ED
authors.lastname: Castro
authors.forename: Tatiana Amodeo
authors.initials: TA
authors.lastname: Tuacek
mesh_terms: D000223:Adaptation, Psychological; D001938:Brazil / Q000453:epidemiology; D003150:Community Health Workers / Q000523:psychology; D005192:Family Health; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008503:Medical Staff / Q000523:psychology; D008603:Mental Health; D009740:Nursing Staff / Q000523:psychology; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology*; D036301:Qualitative Research; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control*; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data; D017132:Workplace / Q000523:psychology*