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Sick on the Job?
Myths and Realities about Mental Health and Work
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- Foreword
- Table of Contents
- Acronyms and abbreviations
- Executive Summary
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Chapter 1. Measuring Mental Health and its Links with Employment
- 1.1. Introduction
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1.2. Defining and measuring mental health and ill-health
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1.3. Towards a better understanding of the characteristics of mental ill-health
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1.4. The rising mental ill-health challenge for the labour market
- 1.5. Conclusion: a framework for analysis and policy development
- Notes
- References
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Chapter 2. Work, Working Conditions and Worker Productivity
- 2.1. Introduction: employment and the workplace are critical
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2.2. Employment, unemployment and the economic cycle
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The relationship between employment status and mental health
- Figure 2.1. Mental disorders are influenced by labour force activity and especially unemployment
- Figure 2.2. Not every unemployed person faces the same risk of poor mental health
- Box 2.1. Does unemployment causally affect individuals’ mental health?
- Figure 2.3. When leaving employment, mental health tends to worsen
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Labour market performance of people with a mental disorder
- Figure 2.4. Unemployment rates are much higher for people with a mental disorder
- Table 2.1. Employment gaps for people with a severe mental disorder are large for men, low-skilled and older workers
- Figure 2.5. The employment and unemployment gap of people with a mental disorder has increased
- Table 2.2. People with a severe mental disorder stay in unemployment for much longer
- Figure 2.6. Unemployed and inactive people with a mental disorder have much lower incomes
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Effect of the economic downturn on mental health problems
- Figure 2.7. Job insecurity is likely to worsen mental health, particularly for those in insecure employment
- Figure 2.8. People experiencing restructuring have lower job satisfaction
- Figure 2.9. Sensitivity of labour market performance of men and women with mental disorders to the business cycle
- Figure 2.10. Employment probabilities of youth and older workers with mental health problems are less sensitive to fluctuations in the business cycle
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The relationship between employment status and mental health
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2.3. The impact of working conditions
- + The quality and structure of employment for workers with mental disorders
- + The current work context
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Work-related stress, job strain and mental health
- Box 2.2. Psychological demands and decision latitude
- Figure 2.14. Job strain has increased over the past decade in all European OECD countries
- Figure 2.15. Workers in low-skilled occupations are much more likely to experience job strain
- Figure 2.16. Job strain increases significantly the chances of having a mental disorder
- Table 2.3. Effect of job strain (demands/controls) on mental health
- Figure 2.17. Respect and recognition at work decrease with severity of a mental disorder
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Policies at the workplace
- Table 2.4. Work-related stress does not receive sufficient attention in workplace risk assessments
- Figure 2.18. Solving mental health problems in the workplace often leads to dismissing the worker
- Table 2.5. Dismissal regulations in regard to sick workers vary considerably across countries
- Table 2.6. In most countries increasing attention is given to awareness campaigns and initiatives
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2.4. Worker productivity as a key challenge
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Trends in sickness absence and presenteeism
- Figure 2.19. Absenteeism and presenteeism both increase sharply with poorer mental health
- Figure 2.20. Presenteeism has increased among all groups of the population
- Table 2.7. Absenteeism and presenteeism levels vary by country but mental health differentials are consistent
- Figure 2.21. Alternative measures of productivity loss all confirm these findings
- + What are the key drivers for sickness absence?
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Trends in sickness absence and presenteeism
- 2.5. Conclusion: towards productive quality employment
- Notes
- References
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Chapter 3. Mental Health Systems, Services and Supports
- + 3.1. Introduction: a multidimensional approach for complex problems
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3.2. Mental disorders, work functioning and employment
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3.3. Under-treatment, adequate treatment and enhanced treatment
- Treatment can improve employment outcomes
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Under-treatment is still pervasive
- Figure 3.4. Treatment rates are extremely low among young adults and gradually increase with age
- + Box 3.3. The increased prescription of antidepressant medication to treat mental disorders
- Figure 3.5. Treatment rates vary with the type of benefit and are highest in welfare recipients
- Figure 3.6. People with a mental health problem who have work problems have higher treatment rates
- Figure 3.7. Workers reporting reduced productivity are increasingly seeking treatment
- In many cases treatment is inadequate
- + Enhanced treatment approaches
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The need for psychotherapy treatment
- Figure 3.9. Medication is significantly more frequent than psychotherapy in all mental disorders
- Figure 3.10. Only a minority of all patients receive combined medication-therapy treatment
- Figure 3.11. Medication is most frequent in the United Kingdom and psychotherapy in Sweden
- Figure 3.12. Treatment modalities in specialised mental health care differ vastly from primary care
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3.4. Mental health care system challenges
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From mental hospitals to community care
- Figure 3.13. Inpatient care has been declining gradually for about three decades
- Table 3.1. Typical providers, services and functions of well-developed mental health care systems
- Figure 3.14. The opportunity to seek specialist treatment varies considerably across countries
- Figure 3.15. The number of psychiatrists has increased everywhere and most in Switzerland
- + The current role of mental health care concerning employment
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From mental hospitals to community care
- 3.5. Conclusion: employment as a goal for the mental health system
- Notes
- References
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Chapter 4. Benefit Systems and Labour Market Services
- 4.1. Introduction: responding to the increase in disability benefit claims
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4.2. Disability benefits: understanding trends, questioning myths
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4.3. Mental ill-health as a predictor of disability benefit awards later in life
- + Pathways into disability benefit
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Is mental ill-health a major factor for disability benefit recipiency?
- Box 4.1. Estimating determinants of disability benefit recipiency (using cross-sectional data) and moves onto disability benefit (using longitudinal data)
- Table 4.2. Mental ill-health itself is a major determinant for disability benefit receipt
- Table 4.3. A worsening of mental health significantly influences moves onto disability benefit
- + Findings from research across the OECD
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4.4. The role of benefits for people with a mental disorder
- + 4.5. Labour market services for people with a mental disorder
- 4.6. Conclusion: towards co-ordinated action of the social security system
- Notes
- References
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Chapter 5. Education Systems and the Transition to Employment
- + 5.1. Introduction: addressing the early onset of mental disorders
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5.2. Mental health problems among children and youth
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5.3. The education system
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5.4. Transition from adolescence to adulthood
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Evidence on higher education and labour market participation
- Figure 5.7. Youth with a severe mental disorder face lower employment but higher unemployment rates
- Figure 5.8. By age 20, more youth who had a mental health problem at age 18 have left education
- Table 5.3. By age 25, US youth with mental ill-health have lower earnings and more job changes
- Table 5.4. Few youth with a mental disorder have ever been diagnosed by a health professional
- + Break in support and services during the transition into adulthood
- + Increasing rates of young adults on disability benefits
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Evidence on higher education and labour market participation
- 5.5. Conclusion: helping school-leavers in their transition to work
- Notes
- References
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Chapter 6. Summary and Conclusions
- + 6.1. Mental health as a new priority challenge for the labour market
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6.2. Evidence on the interface between mental health and work
- Most people with mental disorders are in work
- Work is good for mental health but not under all work conditions
- Productivity losses through mental ill-health are large
- Employment is the best way to secure good incomes
- People with mental disorders often receive unemployment benefits
- The lack of action for the unemployed creates big challenges for the disability benefit system
- Better identification and better policy are hindered by non-disclosure
- Under-treatment is a key challenge for the mental health system
- Providing adequate treatment requires a clearer role for general practitioners
- The mental health system itself needs to change
- + 6.3. New directions for mental health and work policies
The costs of mental ill-health for the individuals concerned, employers and society at large are enormous. Mental illness is responsible for a very significant loss of potential labour supply, high rates of unemployment, and a high incidence of sickness absence and reduced productivity at work. In particular, mental illness causes too many young people to leave the labour market, or never really enter it, through early moves onto disability benefit. Today, between one-third and one-half of all new disability benefit claims are for reasons of mental ill-health, and among young adults that proportion goes up to over 70%. Indeed, mental ill-health is becoming a key issue for the well-functioning of OECD’s labour markets and social policies and requires a stronger focus on policies addressing mental health and work issues. Despite the very high costs to the individuals and the economy, there is only little awareness about the connection between mental health and work, and the drivers behind the labour market outcomes and the level of inactivity of people with mental ill-health. Understanding these drivers is critical for the development of more effective policies. This report aims to identify the knowledge gaps and begin to narrow them by reviewing evidence on the main challenges and barriers to better integrating people with mental illness in the world of work.
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Book Details
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Categories
Business & Economics > International > General
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Publication year : 2012
License: All rights reserved ©
Times read: 0
