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Everyone has the right to decent and productive work in conditions of freedom, equity, security, and human dignity. For people with mental health problems, achieving this right is particularly challenging. The International Labour Organisation's (ILO) mandate on disability issues is laid down in the ILO Convention concerning Vocational Rehabilitation and Employment of Disabled Persons No. 159 (1983), which establishes the principle of equal opportunity and equal
treatment for workers with disabilities. The convention defines a disabled person as an individual whose prospects of securing, retaining, and advancing in suitable employment are substantially reduced as a result of a duly recognized physical or mental impairment.
For decades the ILO has been advocating equal employment opportunities and setting up effective preventive and vocational rehabilitation programmes for people with disabilities. More recently, the importance of specifically addressing the employment of people with mental health difficulties
has been acknowledged. Employees' mental health problems and their impact on enterprise productivity and medical costs are critical human resource issues. Increasingly, trade unions and employers' organisations and government policy makers are realising that the social and economic costs of mental health problems in the workplace cannot be ignored. The ILO's Target Groups Unit, in the Infocus1 Programme on Skills, Knowledge, and Employability, focuses on the human resource needs of vulnerable groups, including individuals with mental health difficulties, and
promotes the inclusion of persons with mental and physical disabilities into mainstream training and employment. The ILO's occupational safety and health programmes, Safe Work and Conditions of Work, complement these activities by dealing with issues of occupational safety and health and working conditions.
This summary and the situation analyses resulting from the project "Mental health in the workplace" highlight the importance of decent work in enhancing the economic and social integration of people with mental health difficulties. They analyse the scope and impact of mental health problems in the labour markets in five countries, Finland, Germany, Poland, the United Kingdom, and the United States, and describe what has been done so far to advance and advocate for employment for people with mental health difficulties.
Introduction
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 absenteeism, 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-skele-
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