Bajo el título Salud Mental y Bienestar en el Lugar de Trabajo, la OMS a través de la World Health Organization ha publicado un informe con el que pretende destacar la importancia de la prevención en materia de Salud Mental (depresión, ansiedad, estrés, adicciones, .....) en el trabajo.
El texto destaca que en esta época de recortes es más necesario que nunca la prevención y la promoción de la salud. El informe señala que los trastornos mentales, ocupan los primeros puestos en las causas de absentismo laboral, con importantes repercusiones en la economía. De ahí la importancia que las organizaciones implementen programas de prevención para ahorrar en costes psicosociales.
El texto destaca que en esta época de recortes es más necesario que nunca la prevención y la promoción de la salud. El informe señala que los trastornos mentales, ocupan los primeros puestos en las causas de absentismo laboral, con importantes repercusiones en la economía. De ahí la importancia que las organizaciones implementen programas de prevención para ahorrar en costes psicosociales.
Conference on Mental Health and Well-being at the Workplace
Protection and Inclusion in Challenging Times
The WHO Regional Office for Europe, the German Alliance for Mental Health, the German
Federal Ministry of Health and the Directorate-General for Health and Consumers of the
European Commission held the Conference on Mental Health and Well-being at the
Workplace – Protection and Inclusion in Challenging Times in Berlin, Germany, on 17 and 18
March 2009. About 130 representatives of user and family caregiver associations, enterprises,
trade unions, politicians and researchers from 20 countries in the WHO European Region
discussed ways to respond to how modern working life challenges mental health and wellbeing,
how to overcome barriers to employment for people with mental health problems and
opportunities for integration and empowerment given the global economic downturn. This
publication is based on the presentations given at the Conference.
Workplace and mental health
Both the Mental Health Declaration for Europe and Mental Health Action Plan for Europe
(WHO Regional Office for Europe, 2005a, b) and the European Pact for Mental Health and
Well-being (European Commission, 2008) recognize the importance of mental health and
well-being and prevention of mental health problems at the workplace as well as overcoming
stigma, discrimination and reintegration. The reasons are easy to explain.
Globally, mental disorders are leading causes of disability. In some high-income countries, as
much as 40% of disability can be attributed to mental disorders. In the WHO European
Region, depression alone causes 13.7% of all years lived with disability, the leading cause.
Alcohol disorders are ranked second with 6.2%, and schizophrenia and bipolar disorders,
much rarer but often lasting many years, rank numbers 11 and 12 respectively with just over
2% each. It is no surprise that policy-makers are concerned about the effects of mental
disorders on society and on the economy.
Associated with the level of disability, mental health problems have become one of the
leading causes for absenteeism from work and early retirement all over the European Region.
Mental health problems in the workplace have serious effects not only for the individual but
also for the productivity and competitiveness of businesses and thus the economy and society
as a whole. Employees’ mental health status affects employees’ performance and rates of
illness, absenteeism and staff turnover. Sickness absenteeism can lead to substantial
productivity losses. Early retirement and exclusion from the labour force due to work-related
stress and mental health problems account for an enormous share of long-term social welfare
benefits. In the United Kingdom, for example, the total cost to employers of mental health
problems among their staff is estimated to be nearly £26 billion each year, equivalent to
£1035 for every employee in the workforce. The business costs comprise £8.4 billion per year
in sickness absence, £15.1 billion per year due to reduced productivity at work and £2.4 billon
per year in replacing personnel who leave their jobs because of mental ill health (Sainsbury
Centre for Mental Health, 2007).
Mental health problems have many effects on the individual at the workplace. The
productivity of individuals with unsupported mental health needs may decline while at work:
presenteeism. Mental health problems can affect work performance in terms of increase in
error rates, poor decision-making, loss of motivation and commitment, tension and conflicts
between colleagues (Harnois & Gabriel, 2000). Burnout and depression as well as stressrelated
physical conditions such as high blood pressure, sleeping disorders and low resistance
to infections can result in an increase in overall sickness absence. Work-related stress and
poor mental health are major reasons not only for absenteeism but also for occupational
disability and for workers seeking early retirement.
Mental disorders affect individuals and their employment much beyond the economic issues.
People with mental disorders face stigmatization, social exclusion and barriers in obtaining
equal opportunities at all levels of life. Finding a job in the open labour market, returning to
work or retaining a job after sickness absence due to mental health problems is often a double
challenge because of the stigma attached to the label “mental”. People with mental health
problems have twice the risk of losing their jobs and are disproportionately out of work.
Mental health and economic recession
The economic recession and its effects on the job market are likely to add to the problems in
employment and quality of life experienced by people with mental health problems and their
families. There is concern that the global economic downturn will adversely affect public
health not only because of job losses but also because of the indirect effect on lifestyles and
access to health care.
Strong evidence indicates that loss of employment and the risk of unemployment are
associated with an increased rate of harmful stress, anxiety, depression and psychotic
disorders. Recent statistical studies show that rising unemployment is also associated with
small but significant short-term increases in premature deaths from suicide (Stuckler et al.,
2009). Unemployment causes significant deterioration of mental health for people of all ages
and especially for middle-aged men.
Loss of employment and/or lower salary cause both loss of income and loss of status. Loss of
income in high-income countries alone has a complex range of effects, some improving health
such as the increased time for physical exercise and reduction in alcohol intake and, more
rarely, reduction in smoking, but loss of employment and lower salary predominantly have
negative effects, both on behaviour and mental health. Loss of employment can result in poor
diet and increasing high-risk behaviour and violence. It can also lead to loss of social contacts,
including divorce, and social withdrawal. The loss of job status can result independently in
physical disorders such as high blood pressure, stroke and cardiovascular disease (Marmot &
Wilkinson, 2006; Wilkinson & Marmot, 2003). In combination, the negative effects of loss of
employment and/or reduction in salary are directly correlated with harmful stress and
depression, which in turn are correlated with a range of physical disorders. As jobs are
threatened and more people need to seek new employment, competition for jobs is expected to
intensify and tolerance of employment difficulty will diminish. Opportunities for people with
a history of mental disorders will fall even further, and discrimination against people with
mental disorders will increase, resulting in a potential spiral of deterioration and deprivation.
In this context, debt is particularly important as a factor causing depression. The recent
downturn with a high prevalence of mortgage arrears and the continued job losses will
continue to make personal debt a severe burden for many vulnerable people. Debt and poor
mental health were clearly linked in a cross-sectional nationally representative survey of
private households in England, Scotland and Wales (Jenkins et al., 2008). According to this
study, both low income and debt are associated with mental illness, but the effect of income is
mediated by debt. Of those with a mental disorder, 23% were in debt versus 8% of those
without a mental disorder. The more debt people had, the more likely they were to have
mental health problems.
Negative effects on dependents cannot be ignored. Children of unemployed people are at
increased risk of dropping out of school and have an increased incidence of disruptive
behaviour. Partners are at risk of depression and its consequences.
Promoting mental health, preventing mental disorders and solutions
During economic recession and the implementation of austerity measures, public sector
spending is carefully considered and cuts are made in areas not considered a priority. Mental
health services specifically and disease prevention and health promotion activities in general
are often cut, and their capacity may paradoxically be reduced at times of increased need.
People with severe and enduring mental health problems are especially likely to be affected
by these cuts, leading to inequitable suffering but also resulting in limited availability of
rehabilitation and supported employment places for people already at disproportionate risk of
exclusion.
Work increases self-esteem and the quality of life. Providing a healthy and inclusive working
environment can prevent mental health problems and enhance opportunities to enter, remain
at or return to work when experiencing such problems. Good health contributes to quality and
productivity at work, which in turn promotes economic growth and employment (McDaid,
2008) and the ability to invest in good employment practices. Numerous measures have been
shown to be effective in promoting mental health and well-being, preventing and managing
mental illness and helping reintegrate people into work – including effective programmes to
tackle stigma and discrimination. Some of the most successful and promising are reflected in
the chapters in the publication, contributions to the Conference on Mental Health and Wellbeing
at the Workplace – Protection and Inclusion in Challenging Times.
Protection and Inclusion in Challenging Times
The WHO Regional Office for Europe, the German Alliance for Mental Health, the German
Federal Ministry of Health and the Directorate-General for Health and Consumers of the
European Commission held the Conference on Mental Health and Well-being at the
Workplace – Protection and Inclusion in Challenging Times in Berlin, Germany, on 17 and 18
March 2009. About 130 representatives of user and family caregiver associations, enterprises,
trade unions, politicians and researchers from 20 countries in the WHO European Region
discussed ways to respond to how modern working life challenges mental health and wellbeing,
how to overcome barriers to employment for people with mental health problems and
opportunities for integration and empowerment given the global economic downturn. This
publication is based on the presentations given at the Conference.
Workplace and mental health
Both the Mental Health Declaration for Europe and Mental Health Action Plan for Europe
(WHO Regional Office for Europe, 2005a, b) and the European Pact for Mental Health and
Well-being (European Commission, 2008) recognize the importance of mental health and
well-being and prevention of mental health problems at the workplace as well as overcoming
stigma, discrimination and reintegration. The reasons are easy to explain.
Globally, mental disorders are leading causes of disability. In some high-income countries, as
much as 40% of disability can be attributed to mental disorders. In the WHO European
Region, depression alone causes 13.7% of all years lived with disability, the leading cause.
Alcohol disorders are ranked second with 6.2%, and schizophrenia and bipolar disorders,
much rarer but often lasting many years, rank numbers 11 and 12 respectively with just over
2% each. It is no surprise that policy-makers are concerned about the effects of mental
disorders on society and on the economy.
Associated with the level of disability, mental health problems have become one of the
leading causes for absenteeism from work and early retirement all over the European Region.
Mental health problems in the workplace have serious effects not only for the individual but
also for the productivity and competitiveness of businesses and thus the economy and society
as a whole. Employees’ mental health status affects employees’ performance and rates of
illness, absenteeism and staff turnover. Sickness absenteeism can lead to substantial
productivity losses. Early retirement and exclusion from the labour force due to work-related
stress and mental health problems account for an enormous share of long-term social welfare
benefits. In the United Kingdom, for example, the total cost to employers of mental health
problems among their staff is estimated to be nearly £26 billion each year, equivalent to
£1035 for every employee in the workforce. The business costs comprise £8.4 billion per year
in sickness absence, £15.1 billion per year due to reduced productivity at work and £2.4 billon
per year in replacing personnel who leave their jobs because of mental ill health (Sainsbury
Centre for Mental Health, 2007).
Mental health problems have many effects on the individual at the workplace. The
productivity of individuals with unsupported mental health needs may decline while at work:
presenteeism. Mental health problems can affect work performance in terms of increase in
error rates, poor decision-making, loss of motivation and commitment, tension and conflicts
between colleagues (Harnois & Gabriel, 2000). Burnout and depression as well as stressrelated
physical conditions such as high blood pressure, sleeping disorders and low resistance
to infections can result in an increase in overall sickness absence. Work-related stress and
poor mental health are major reasons not only for absenteeism but also for occupational
disability and for workers seeking early retirement.
Mental disorders affect individuals and their employment much beyond the economic issues.
People with mental disorders face stigmatization, social exclusion and barriers in obtaining
equal opportunities at all levels of life. Finding a job in the open labour market, returning to
work or retaining a job after sickness absence due to mental health problems is often a double
challenge because of the stigma attached to the label “mental”. People with mental health
problems have twice the risk of losing their jobs and are disproportionately out of work.
Mental health and economic recession
The economic recession and its effects on the job market are likely to add to the problems in
employment and quality of life experienced by people with mental health problems and their
families. There is concern that the global economic downturn will adversely affect public
health not only because of job losses but also because of the indirect effect on lifestyles and
access to health care.
Strong evidence indicates that loss of employment and the risk of unemployment are
associated with an increased rate of harmful stress, anxiety, depression and psychotic
disorders. Recent statistical studies show that rising unemployment is also associated with
small but significant short-term increases in premature deaths from suicide (Stuckler et al.,
2009). Unemployment causes significant deterioration of mental health for people of all ages
and especially for middle-aged men.
Loss of employment and/or lower salary cause both loss of income and loss of status. Loss of
income in high-income countries alone has a complex range of effects, some improving health
such as the increased time for physical exercise and reduction in alcohol intake and, more
rarely, reduction in smoking, but loss of employment and lower salary predominantly have
negative effects, both on behaviour and mental health. Loss of employment can result in poor
diet and increasing high-risk behaviour and violence. It can also lead to loss of social contacts,
including divorce, and social withdrawal. The loss of job status can result independently in
physical disorders such as high blood pressure, stroke and cardiovascular disease (Marmot &
Wilkinson, 2006; Wilkinson & Marmot, 2003). In combination, the negative effects of loss of
employment and/or reduction in salary are directly correlated with harmful stress and
depression, which in turn are correlated with a range of physical disorders. As jobs are
threatened and more people need to seek new employment, competition for jobs is expected to
intensify and tolerance of employment difficulty will diminish. Opportunities for people with
a history of mental disorders will fall even further, and discrimination against people with
mental disorders will increase, resulting in a potential spiral of deterioration and deprivation.
In this context, debt is particularly important as a factor causing depression. The recent
downturn with a high prevalence of mortgage arrears and the continued job losses will
continue to make personal debt a severe burden for many vulnerable people. Debt and poor
mental health were clearly linked in a cross-sectional nationally representative survey of
private households in England, Scotland and Wales (Jenkins et al., 2008). According to this
study, both low income and debt are associated with mental illness, but the effect of income is
mediated by debt. Of those with a mental disorder, 23% were in debt versus 8% of those
without a mental disorder. The more debt people had, the more likely they were to have
mental health problems.
Negative effects on dependents cannot be ignored. Children of unemployed people are at
increased risk of dropping out of school and have an increased incidence of disruptive
behaviour. Partners are at risk of depression and its consequences.
Promoting mental health, preventing mental disorders and solutions
During economic recession and the implementation of austerity measures, public sector
spending is carefully considered and cuts are made in areas not considered a priority. Mental
health services specifically and disease prevention and health promotion activities in general
are often cut, and their capacity may paradoxically be reduced at times of increased need.
People with severe and enduring mental health problems are especially likely to be affected
by these cuts, leading to inequitable suffering but also resulting in limited availability of
rehabilitation and supported employment places for people already at disproportionate risk of
exclusion.
Work increases self-esteem and the quality of life. Providing a healthy and inclusive working
environment can prevent mental health problems and enhance opportunities to enter, remain
at or return to work when experiencing such problems. Good health contributes to quality and
productivity at work, which in turn promotes economic growth and employment (McDaid,
2008) and the ability to invest in good employment practices. Numerous measures have been
shown to be effective in promoting mental health and well-being, preventing and managing
mental illness and helping reintegrate people into work – including effective programmes to
tackle stigma and discrimination. Some of the most successful and promising are reflected in
the chapters in the publication, contributions to the Conference on Mental Health and Wellbeing
at the Workplace – Protection and Inclusion in Challenging Times.
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