Finland provides an example of an extensive occupational health care service system that reaches 90 % of the workforce. Occupational health care services are also responsible for providing rehabilitation services for employees. Mental health issues have not traditionally belonged to the domain of occupational health care services, but their importance to employees' work ability has been recognised, and more attention and resources have been devoted to them. In the USA and the UK, where the occupational health care services operate on a different basis, Employee Assistance Programmes (EAP) are becoming a more common and popular means to provide counselling and confidential information. EAP services are independent of but financed by employers.
THE ROLE OF GOVERNMENT AND SOCIAL PARTNERS
Governments play an important role in formulating policies that affect labour market developments and health care and social services. All the situation analyses identify various national agencies and bodies that contribute to the issues related to mental health in the workplace. For instance, in the USA, the National Institute on Disability and Rehabilitation Research and the Center for Mental Health Services have been promoting the ADA and providing technical advice resulting in implementation. A recent UK government White Paper recognises mental health difficulties as a major cause of ill health, disability, and early mortality in the UK and gives priority to development of extensive mental health care services. A Finnish governmental agency, the National Research and Development Centre for Welfare and Health (STAKES), has been an active advocate for mental health issues in the European Union. In Germany, the government is committed to equal opportunities. However, as the German review notes, legal regulations, institutions, and services cannot always do more than provide the framework for integration.
The reviews acknowledge the importance of collaboration between workers' and employers' organizations in addressing mental health issues. The Finnish and German reports illustrate employers' and workers' interest in tackling issues such as mobbing, time pressure, stress, and impact of technology as they relate to employee's work ability. In the UK both the employers and workers are campaigning against work-related stress and have participated in discussions concerning the development of DDA. The USA employers and workers have shown interest in preventing violence in the workplace, advocating for mental health benefits, and providing information concerning accommodations, ADA, recruitment etc. The Polish report describes a lack of interest on the part of both workers and employers in advancing the employment of people with mental health problems.
In all the five countries non-governmental organisations (NGOs) play a vital role in raising awareness of mental health issues, disseminating information, providing services, and reducing stigma surrounding mental health issues. NGOs have organized successful national campaigns and programmes to create awareness of mental health issues such as depression (USA, UK), suicide (Finland) and mental health promotion in the workplace (Poland). It is generally acknowledged that open communication and co-operation between NGOs, government agencies, and employees' and employers' organizations is important in guaranteeing good services for people with mental health problems.
Each report identifies academic institutions that are engaged in research on mental health related issues in the workplace. It is generally recognised, however, that the current knowledge base is not complete despite enormous advances during the last decade in research on the identification, causes, and treatment of mental disorders. This is particularly evident in regards to the impact of work as a precipitating factor in the onset of depression or other mental health problems.
