O suicídio e as tentativas de suicídio entre trabalhadores e trabalhadoras no Ceará: estratégias de enfrentamento

Abstract

Suicide is a multifactorial phenomenon and constitutes a public health problem among the working population. This study aimed to propose strategies to improve actions for the prevention and surveillance of suicide among workers in the state of Ceará. It is a quantitative–qualitative, descriptive, and exploratory investigation conducted in Ceará, including data from 2012 to 2022 from the Mortality Information System (SIM) and the Notifiable Diseases Information System (SINAN). Statistical analysis employed absolute and relative frequencies using STATA software. Qualitative data were collected through focus groups with technical staff and managers from the Workers’ Health Reference Center (CEREST). The main findings revealed that agricultural and livestock workers accounted for 21,3% of suicide lethality, while homemakers predominated in suicide attempts with 15.4%. Among suicide deaths, men, single individuals, and those with low educational attainment had the highest proportions, whereas suicide attempts were more frequent among women, single individuals, and those with low schooling. The qualitative analysis identified challenges within the workers’ health surveillance network, particularly the discontinuity of care and lack of coordination across all levels of healthcare, as well as the insufficient preparedness of professionals in key sectors to establish causal links. The principal strategies proposed included the integration of health surveillance systems, strengthened collaboration with primary care, the use of data technologies, and permanent professional education. Moreover, suicide and suicide attempts among workers are characterized as outcomes of multiple interconnected factors reflecting social determination mediated by capitalist processes of exploitation. The study concludes that structural changes and integrated public policies involving employment, social protection, mental health, and workers’ health surveillance are needed. It highlights the importance of permanent education and the incorporation of work-related dimensions into healthcare practices. Regarding suicide attempts, multiprofessional training, the establishment of care pathways, and enhanced coordination among hospital epidemiological units, workers’ health surveillance, and sanitary surveillance are recommended. The study advocates for network integration through efficient communication and technological tools to support surveillance and continuity of care, with primary healthcare as a central component. The proposed strategies depend on strong state commitment, adequate funding, and recognition of work-related suicide as a preventable public health issue.