Mental illness in the workplace: a growing risk

Mental illness and substance use disorders are the leading cause of disability worldwide.

Mental illness in the workplace: a growing risk
In Europe alone, almost 165 million people have experienced mental illness during the past year. In 2010, this was associated with an estimated cost of €461 billion1.

In Portugal, the rate of previous year mental disorder is around 22% which is relatively high in Europe and is associated with significant levels of disability in the workplace in addition to personal and family life.2

Much of the costs associated with mental illness result from productivity losses associated with absenteeism and presenteeism (i.e., workers with mental health problems attending work whilst unwell) in the workplace. Nevertheless, despite the high prevalence and significant economic costs, mental illness is an issue which is often underestimated in the workplace.

Some data suggest that absenteeism and early retirement as a result of mental illness, appear to be increasing across Europe3. In Germany, for example, the contribution of mental illness to the cost of permanent disability pensions has tripled in the past 20 years. 

Manager responses which focus on offering help to an employee with a mental illness can help to increase positive attitudes about people with mental illness in the workplace4 and also, openness and disclosure of employees with mental health problems. 

By doing so, employees will feel more comfortable in discussing any potential mental health issues early on and will have better chances at getting the help and support that they need to recover. Responses, such as flexible working hours, may be helpful but are not necessarily sufficient to support the employee with the mental health problem. 

It is critical that managers and co‑workers also provide support and an open environment in addition to flexible working hours.

In a study of seven European countries5 which focused specifically on depression, we investigated the social and economic impact of depression in the workplace and access to support and/or treatment in order to mitigate the risk and impact of depression in the workplace. 

We found that about 20% of employed respondents reported having a previous diagnosis of depression. Among employees with diagnosis of depression, between 20 and 55% reported taking time off of work dueto depression.

Employers, managers and co‑workers can play an important role in supporting employees with mental health problems. Working environments that promote social acceptance of employees with mental health problems may mitigate the adverse impact and risk of mental health problems in the workplace. 

Both manager reactions and organisational factors may influence how people with mental health problems are perceived and treated in the workplace and hence openness and disclosure among employees with mental health problems. 

These factors are important facilitators of social inclusion, which is what a person with mental health problems needs. 

A better option to tackle mental illness in the workplace is for managers to offer direct help to depressed employees. Managers who avoid discussing an employee’s depression are only adding to the general ignorance of mental illness and not helping either the company or the staff member.

Other research has emphasised the importance of positive attitudes in relation to social acceptance of people with mental illness as a key factor driving stigma and discrimination and has shown a direct link between attitudes and the experiences of people with mental illness. 

Anti‑stigma interventions which challenge myths and misperceptions and promote social contact between people with and without mental health problems have made important steps in addressing stigmatising attitudes, yet stigma is still a major barrier in the area of employment and many employers are not dealing with it adequately.

In the context of what we know, recommendations can be made for employers and policymakers about how to best translate evidence about workplace mental health into practice and to improve the workplace context for people with mental illness and businesses.

In particular, three areas of focus could lead to improvements: (1) support and training for employees, managers and other relevant staff; (2) complete support from the top of the organization through enactment of supportive policies and practices for both prevention and treatment of mental illness and (3) a focus on earlier support and intervention to reduce the gap between recognition and treatment. In view of increasing absenteeism attributable to depression and the economic consequences associated with this, the need for better workplace policies is evident.

1 - Wittchen H‑U, Jacobi F, Rehm J, et al. The size and burden of mental disorders and other disorders of the brain in Europe 2010. Eur Neuropsychopharmacol2011; 21:655–79. 
2 - Graça Cardoso, Miguel Xavier, Gemma Vilagut, Maria Petukhova, Jordi Alonso, Ronald C. Kessler, José Miguel Caldas‑de‑Almeida. Days out of role due to common physical and mental conditions in Portugal: results from the WHO World Mental Health Survey. British Journal of Psychiatry Open Feb 2017, 3 (1) 15‑ 21
3 - McDaid D, Curran C, Knapp M (2005) Promoting mental well‑being in the workplace: a European policy perspective. Int Rev Psychiatry 17: 365‑ 373. Url http://sites.google.com/ site/fpcerhto/McDaid2005.pdf
4/5 - Evans‑Lacko S, Knapp M (2014) Importance of Social and Cultural Factors for Attitudes, Disclosure and Time off Work for Depression: Findings from a Seven Country European Study on Depression in the Workplace. PLoS ONE 9(3): e91053. doi:10.1371/journal.pone.0091053

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