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WORLD OF WORK
No. 37, December 2000
No. 37, December 2000
S.O.S. Stress at work:
with depression increasingly common
Working more and enjoying it less? If so, you’re not alone. A new ILO study1 finds mental health in the world of work in peril. Employees report burnout, anxiety, low morale and stress - all of which can mean loss of work. Employers report lower productivity, reduced profits and high turnover rates. And for governments, this epidemic translates into higher health care costs and lower national income. This report looks at mental health on the job, and what people can do about it.
GENEVA - In Finland, high unemployment, job insecurity, short-term contracts and time pressure coincided with a marked deterioration in the reported mental well being of the workforce.
In Germany, workers dealing with "rationalization and the rapid introduction of technology" along with rising unemployment, suffered from stress due to increased time pressure and demands for greater quality and quantity of production.
In the United States and the United Kingdom, an array of new technologies and methods of work organization stemming from rising productivity requirements is causing more cases of depression and work-induced stress.
And in Poland, major political changes leading to socio-economic transformation "had serious ramifications for the labour market and for the mental wellbeing of people in the workplace".
These finding are from a new report, Mental health in the workplace: Introduction prepared by the ILO. The report notes that while the origins of mental health difficulties are complex and the workplace practices and income and employment patterns differ widely among the countries studied, a number of common threads appear to link the high prevalence of stress, burnout and depression to changes taking place in the labour market, due partly to the effects of economic globalization.
The study of mental health policies and programmes affecting the workforces of Finland, Germany, Poland, the United Kingdom and the United States shows that the incidence of mental health problems is increasing, with as many as one in ten workers suffering from depression, anxiety, stress or burnout, which lead, in some cases, to unemployment and hospitalization.
The countries were chosen not because they have inordinately high incidences of mental illness, but because they are emblematic of different approaches to workplace organization and welfare systems, embodying different types of legislation, health care, and approaches to mental health issues.
Disturbing trends
Ms. Phyllis Gabriel, a vocational rehabilitation specialist and one of the main authors of the mental health study, expressed alarm at the widespread costs of these disturbing trends:
"Employees suffer from low morale, burnout, anxiety, stress, lost income and even unemployment associated in some cases with the inevitable stigma attached to mental illness," she said. "For employers, the costs are felt in terms of low productivity, reduced profits, high rates of staff turnover and increased costs of recruiting and training replacement staff. For governments, the costs include health care costs and insurance payments as well the loss of income at the national level."
The series of detailed country studies address such issues as workplace productivity, loss of income, health care and social security costs, access to mental health services and employment policies for the people with mental illness. The ILO undertook the study because, as Ms. Gabriel emphasized, "the workplace is an appropriate environment for educating individuals and raising their awareness of mental health difficulties in order to target mental health problems and prevent them from developing".
The report estimates that anywhere from 3 to 4 per cent of GNP is spent on mental health problems in the European Union. In the US, the national spending associated with treatment of depression ranges between US$30 billion and US$44 billion. In many countries, early retirement due to mental health difficulties is increasing to the point where they are becoming the most common reason for allocating disability pensions.
Congress on Mental Health in the Workplace
The ILO hosted a two-day Congress on 9 and 10 October on the topic of Mental Health in the Workplace, organized by World Strategic Partners, a US-based international health industry network aiming to promote innovative thinking in health care policy and services, in collaboration with the World Federation for Mental Health, a nongovernmental organization based in the Netherlands which aims to de-stigmatize mental illness and promote social and economic opportunities for people affected.
At the close of the Congress, to mark World Mental Health Day on 10 October, the ILO jointly organized a Symposium on Mental Health and Work, in cooperation with the World Health Organization and the Federation. ILO Director-General Juan Somavia spoke at the Symposium.
Five country examples
Among the major findings of the report, which warns that the costs of mental health disability are rising, is a pattern of increasing personal and and mental health problems among the working age populations of all the countries studied. For example:
- In the US, clinical depression has become one of the most common illnesses, affecting one in ten working age adults each year, resulting in a loss of approximately 200 million working days per year;
- In Finland, over 50 per cent of the workforce experiences some kind of stress-related symptoms, such as anxiety, depressive feelings, physical pain, social exclusion or sleep disorders; 7 per cent of Finnish workers suffer from severe burnout, leading to exhaustion, cynicism and sharply reduced professional capacity and mental health disorders are the leading cause of disability pensions in Finland;
- In Germany, depressive disorders account for almost 7 per cent of premature retirements and depression-related work incapacity lasts about two-and-a-half times longer than incapacity due to other illnesses. The annual volume of production lost because of absenteeism related to mental health disorders is estimated at over 5 billion DM annually;
- In the UK, each year nearly three out of every ten employees experience mental health problems, and numerous studies indicate that work-related stress and the illnesses it causes are common. Depression, in particular, is such a common problem that at any given time one in every 20 working-aged Britons is experiencing major depression;
- Public health statistics in Poland indicate growing numbers of people - especially individuals suffering from depressive disorders - receiving mental health care, a trend which can be related to the country's socio-economic transformation and resulting increases in unemployment, job insecurity and declining living standards.
Is progress being made?
The ILO report sees progress in coming to terms with mental health issues in the workplace in all the countries studied. It notes, for example, that "in the US, employers of all sizes are beginning to recognize that depressive disorders often constitute their highest mental health (medical) and disability cost. A large number of employers understand the relationship between health and productivity and are improving their management strategies by developing and implementing programs supportive of work/family/life issues."
Finland, the report notes, has actively started to address mental health issues, both at the national and international levels, adding that "the culture of mental health promotion is evolving in the workplace; the Finnish concept of work ability is not just about promoting employees' physical health but also about mental health in healthy work organizations".
In Germany, which already enjoys strong institutional and government support for mental health services, corporate health promotion is becoming a higher priority and successful stress reduction programmes have been underway for many years. These programmes include "relaxation procedures, role-playing and behavioural training to increase self-confidence and improve interpersonal skills".
In the UK, employees' and employers' organizations play an active role in mental health issues, and the Government and institutional response to the issue is generally proactive.Some companies have already developed mental health policies for the workplace.Analysis of existing policies has defined certain key elements of good practice, the report notes, adding that "the most fundamental step for organizations is to recognize and accept that mental health is an important issue, and show commitment to mental health promotion".
1 Mental health in the workplace: Introduction. Prepared by Ms. Phyllis Gabriel and Ms. Marjo-Riitta Liimatainen. International Labour Office, Geneva, October 2000. ISBN 92-2-112223-9.