tal disorders, and they are a major reason for granting disability pensions in several countries. The United Nations estimates that 25% of the entire population is adversely affected in one way or another as a result of disabilities.²

Mental health problems do not just affect the individual. They impact the entire community. The cost of excluding people with mental health difficulties from an active role in community life is high. Exclusion often leads to diminished productivity and losses in human potential. The cost of mental health problems, and of other disabilities, has three components:³

* the direct cost of welfare services and treatment, including the costs of disability benefits, travel, access to services, medication etc;

* the indirect cost to those who are not directly affected such as caregivers ;

* the opportunity costs of income foregone due to incapacity.

People with mental health difficulties face environmental, institutional and attitudinal barriers in finding mainstream employment or returning to work and retaining jobs after treatment. Attitudinal barriers and social exclusion are often the hardest obstacles to overcome and usually are associated with feelings of shame, fear, and rejection.⁴

Stigma surrounds people with mental health difficulties, and the recovery process is often misunderstood. Stigmatisation can negatively affect the success of vocational efforts. For example, it has been reported that many professional workers who either resign a job or take a medical leave related to a mental illness episode, such as depression, experience difficulty maintaining a stigma-free relationship with their employers. Those returning to the same work environment find that performance and behavioural difficulties, which initially interrupted their work, have altered their employers' and co-workers' perception of their professional abilities.⁵

It is clear that mental health problems can impose a heavy burden in terms of social exclusion, stigmatisation, and economic costs for people with mental health difficulties and their families. Unfortunately, the future burden is likely to grow over time as a result of the ageing of the population and stresses resulting from social problems and unrest, including violence, conflict, and natural disasters.⁶ In many countries, however, policy makers and service providers have recognised the need to take steps to prevent problems from arising and to respond more effectively to the growing need for mental health care services.

USING THE WORKPLACE TO PREVENT, IDENTIFY, AND PROVIDE SOLUTIONS FOR REFERRAL AND REHABILITATION

The workplace is an appropriate environment in which to educate individuals and raise their awareness about mental health difficulties and target mental health problems and prevent them from developing. Promotion of good mental health practices can be part of human resource management policy, and occupational health care services can play an important role in early recognition and identification of mental health difficulties in the workplace. This does not, however, ignore the multidimensional nature of effective mental health services or the mutiplicity of factors contributing to an individual's mental health.

The development of mental health problems is complicated, and often there is no single or identifiable cause. Nonetheless, there are risk factors that may trigger mental health problems in certain people, including heredity, negative life events, certain medications, diseases or illnesses, and work-related stress. Ultimately, whatever the causal factors, the high prevalence