depressive responses. In 1993 a training courses on "Social work with the unemployed," supported by funds from PHARE*, were offered in 13 out of Poland's 49 administrative districts. A total of 180 participants completed the training

*PHARE was established by the European Commission to assist countries of Central and Eastern Europe in reconstructing their economies in the 1990s. Initially targeted at Poland and Hungary, it now includes 13 countries in the region. In addition to economic issues it covers health and social issues.

Disability

In Poland there is a process for legally certifying disability due to mental health disorders and awarding disability benefits. These benefits include: disability pension and social welfare assistance such as home care provided by community nurses or residence in a nursing home or a community mental health facility. People with mental health disorders are also in the category of the disabled who are entitled to legal and financial support when they enter paid employment.

According to the Central Statistical Office, in 1996¹⁸ there were 5.15 million disabled people in Poland. Of that number over 4.1 million received disability pensions. Of these, 1. 45 million people (over 28%) were disabled due to mental health disorders. Over 311,000 (about 6% of the total disabled) suffered from severe mental illness. Of those, 271,000 received disability pensions.

Slightly over one sixth of all disabled people are employed. Over 84% of the mentally ill are inactive. There are no data indicating how many of those reporting an occupational activity (16% of people with mental health disorders) are in paid employment. The experience of professionals involved in their treatment and rehabilitation indicates that the vast majority of people with mental health disorders are unemployed and only a few secure employment. For those who do obtain work, there was no information indicating how long they were able to maintain a job.

According to Social Security Agency statistics, 250,500 people received their first disability pension in 1996. In 34,900 cases (14%), the disability was due to mental illness.¹⁹

Prevention and promotion

According to Article 4 of the Mental Health Act, "preventive measures with respect to mental health shall be targeted first and foremost at children, adolescents, the elderly, and people in situations involving risk to their mental health." An executive regulation added by the Minister of Health and Social states that "activities in the field of mental health promotion and prevention of mental health disorders shall be implemented above all...in the form of psycho-educational initiatives, and development of skills necessary to the individual for the formation of appropriate interpersonal relations in the workplace." The Minister of Health and Social Welfare appointed a Council for Mental Health Promotion affiliated with the Institute of Psychiatry and Neurology. The aims of the Council include the development of a programme of activities for mental health promotion and prevention of mental health disorders. The programme will cover mental health promotion in the workplace. The input of experts from other countries in this work would be greatly appreciated.