tinent to mental health in the selected countries, but they provide an overall review of the situation. Each situational analysis examines the following areas:

Mental health at the national level: common knowledge, individuals' access to information; work and unemployment; policy and legislative framework; the economic burden of mental illness;

The role of government and social partners: key governmental agencies and their role; implementing law and policy; the role of workers', employers', and non-governmental organizations and noted academic institutions;

Employer practices in the workplace: examples of enterprise prevention policies and programmes; work -family issues and their impact on productivity.

Overview

The literature reviews provide an overview of mental health issues in the workplace in Finland, Germany, Poland, UK, and USA. They demonstrate both significant differences and similarities between the countries in how mental health issues are addressed in the context of competitive employment. The legislative, political, social, and economic differences provide the framework for the design and delivery of health care, including mental health services, and the way mental health issues are addressed in the workplace. Moreover, the general labour market situation varies in the five countries, with differing needs and resources to respond to those needs. For instance, the United States and the United Kingdom currently enjoy low unemployment rates, whereas unemployment has been, and still remains, a persistent problem in continental Europe. Because of the economic recession of the early 1990s, job insecurity has been a pressing issue, particularly, in Finland and Poland. Union membership also varies greatly among the counties.

Similarities and differences across the five countries

^{SIZE OF THE PROBLEM}

In all five countries the incidence of mental health problems and the costs related to them have risen during the past decade. The increase in the incidence of depression, in particular, is alarming. However, as the Finnish and German reviews note, the figures do not necessarily reflect an absolute increase. Changes in the diagnostic system, more open attitudes, and improved diagnoses and recognition may contribute to the increase in diagnosed mental health problems. However, at any given time, it is estimated that approximately 20% of the adult population have a mental health problem.

Less severe mental health problems which may trigger depression are also common. In Finland over 50% of the workforce experience some kind of stress related symptoms, such as anxiety, depressive feelings, physical pain, social exclusion, and sleep disorders. Poland has recently begun to study the correlation between work stress and health status, with a view to developing preventive programs, particularly for people in high stress jobs such as firemen, policemen, and ambulance service workers. Both the German and Finnish studies identify job insecurity, time pressure, and lack of opportunity for career development as potential stress indicators in the workplace. The issues of stress, burnout, and prevention have also been under scrutiny