title: Consequences of intangibility in the management of new mental health services.
abstract: OBJECTIVE
  To analyze work organization in psychosocial healthcare services from the logic of the service management field.
  
  
  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 five sources of information were analyzed: Ministério da Saúde (Brazilian 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 difficult to be defined 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 finds it difficult 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 insufficiency of the municipal health system's management structure to include a service of this nature. Results enabled better understanding of a field of work where workers' and users' subjectivity is inherent in the service management process.
authors: Departamento de Engenharia de Produção, Escola Politécnica, Universidade de São Paulo, 05508-070 São Paulo, SP, Brasil. mtdsilva@usp.br
authors: Marcia Terra da
authors: MT
authors: Silva
authors: Selma
authors: S
authors: Lancman
authors: Carolina Maria do Carmo
authors: CM
authors: Alonso
mesh_terms: D001938:Brazil; D006282:Health Personnel / Q000458:organization & administration; D006801:Humans; D007407:Interviews as Topic; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D019982:Organizational Case Studies; D015397:Program Evaluation; D011788:Quality of Life; D012949:Social Work, Psychiatric / Q000458:organization & administration