MENTAL HEALTH AND DISABILITY
Mental health difficulties can affect an individual’s functional and
working capacity in numerous ways. Depending on an individual’s
age at the onset of a mental health problem, his or her working capacity
can be significantly reduced. In the workplace, this can lead to absen-
teeism, require sick leave, and reduce productivity. Long-term mental
health difficulties are, according to a WHO report, one of the three leading
causes of disability, along with cardiovascular disease and musculo-skeletal disorders, and they are a major reason for granting disability pensions in
several countries. The United Nations estimates that 25% of the entire pop-
ulation is adversely affected in one way or another as a result of disabilities.2
Mental health problems do not just affect the individual. They impact the
entire community. The cost of excluding people with mental health difficul-
ties from an active role in community life is high. Exclusion often leads to
diminished productivity and losses in human potential. The cost of mental
health problems, and of other disabilities, has three components:3
• the direct cost of welfare services and treatment, including the costs
of disability benefits, travel, access to services, medication etc;
• the indirect cost to those who are not directly affected such as care-
givers ;
• the opportunity costs of income foregone due to incapacity.
People with mental health difficulties face environmental, institutional and
attitudinal barriers in finding mainstream employment or returning to work
and retaining jobs after treatment. Attitudinal barriers and social exclusion
are often the hardest obstacles to overcome and usually are associated with
feelings of shame, fear, and rejection.4
Stigma surrounds people with mental health difficulties, and the recovery
process is often misunderstood. Stigmatisation can negatively affect the
success of vocational efforts. For example, it has been reported that many
professional workers who either resign a job or take a medical leave related
to a mental illness episode, such as depression, experience difficulty main-
taining a stigma-free relationship with their employers. Those returning to
the same work environment find that performance and behavioural difficul-
ties, which initially interrupted their work, have altered their employers’
and co-workers’ perception of their professional abilities.5
It is clear that mental health problems can impose a heavy burden in terms
of social exclusion, stigmatisation, and economic costs for people with men-
tal health difficulties and their families. Unfortunately, the future burden
is likely to grow over time as a result of the ageing of the population and
stresses resulting from social problems and unrest, including violence, con-
flict, and natural disasters.6 In many countries, however, policy makers and
service providers have recognised the need to take steps to prevent problems
from arising and to respond more effectively to the growing need for mental
health care services.
USING THE WORKPLACE TO PREVENT, IDENTIFY, AND PROVIDE SOLUTIONS
FOR REFERRAL AND REHABILITATION
The workplace is an appropriate environment in which to educate indi-
viduals and raise their awareness about mental health difficulties and
target mental health problems and prevent them from developing.
Promotion of good mental health practices can be part of human resource
management policy, and occupational health care services can play an
important role in early recognition and identification of mental health diffi-
culties in the workplace. This does not, however, ignore the multidimen-
sional nature of effective mental health services or the mutiplicity of factors
contributing to an individual’s mental health.
The development of mental health problems is complicated, and often there
is no single or identifiable cause. Nonetheless, there are risk factors that
may trigger mental health problems in certain people, including heredity,
negative life events, certain medications, diseases or illnesses, and work-
related stress. Ultimately, whatever the causal factors, the high prevalenceof mental health problems among employees makes them a pressing issue
in their own right.7 Some mental health problems require clinical care and
monitoring as well as special consideration for the integration or re-inte-
gration of the individual into the labour market.
It is important to recognise that minimising work-related stressors and pro-
moting good mental health through workplace policies can help prevent
mental health problems from developing. In terms of job retention and
return to work after sick leave, most individuals will recover from mental
health difficulties completely, and in due course, return to work as before.8
Depression, for instance, may be prevented in many cases, and if it strikes,
may be successfully treated in 80% of all cases.9 People recovering from
depression, which is recognised and given the appropriate medical treat-
ment, may only require limited time or adjustment before returning to
work.
Promotion of mental health in the workplace is all the more relevant in the
context of a nearly universal market economy in which the pace of econom-
ic activities is fast, contractual relationships start and terminate at short
notice, and international competition is intensified. While globalisation has
opened up new opportunities for powerful and dynamic development and
growth of the world economy, it does not benefit every person or region in
the world equally. The key elements that globalisation has brought are
increasing automation, rapid implementation of information technology,
and the need for more flexible and responsive work methods. Workers
worldwide confront, as never before, an array of new organisational struc-
tures and processes which can affect their mental health. These include
downsizing, layoffs, mergers, contingent employment, and increased work
load. To guarantee the best results in international competition, it is in the
interest of employers to provide their employees with decent working conditions.
