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Prevention is the professional responsibility of physicians trained in occupational medicine. However, since there are no detailed statutes governing the prevention of mental health disorders, preventive interventions are not taking place. In 1992, at a conference on unemployment²⁰ and its consequences, the following recommendations were made: that multidisciplinary centres for counselling and assistance to the unemployed be established; that preventive interventions by medical services take place in workplaces threatened with restructuring; and that there be more and better training of health care and social welfare staff in workplace issues. However, no information on implementation of these recommendations is available. So far, there is no nation-wide data bank of information on preventive and therapeutic interventions in the case of people who develop mental health disorders in response to job loss.

In preparing this report, no information was found on workplace policies or programmes relating to prevention of mental health disorders or on the evaluation of workplace health promotion programmes. If such initiatives are occurring in Poland it is due to local mental health professionals, and they have not been publicised.

There have been some sporadic efforts by employers to develop anti-stress programs in the workplace. The Institute of Occupational Medicine conducted a survey of 812 successful Polish enterprises, which were members of the Business Centre Club. These firms were expected to be leaders in promoting health in the workplace. The response rate was 11% (93 firms). Only 14 of the respondents reported having a stress management programme, while 32 had alcohol prevention programmes.²¹

Steps which have been taken in the area of promoting good mental health practices in the workplace include:

* preparing guidelines on stress management in the workplace;

* providing occupational medical practitioners with training courses and seminars on stress management in the workplace;

* developing a set of instruments for assessing the impact of workplace stress;

* designing methods for evaluating and identifying persons at risk for physical and mental health problems due to work-related stress. ²²

In 1997 a National Centre of Workplace Health Promotion was established at the Institute of Occupational Medicine, at Lódz.²³ The Centre's main purpose is to "support implementation of comprehensive health promotion programmes in Polish companies." Its work is based on the concept that a company's health promotion program exists within the context of it human resources policy to enhance profitability through activities which ensure the good health of employees. Because health promotion in the workplace is a new concept in Poland, part of the Centre's challenge lies in educating management to the importance of this approach and creating a business culture which is friendly to its implementation. The Centre has undertaken the following activities:

* Promulgating the concept of health promotion in the workplace among occupational health professionals (physicians and nurses), people responsible for work safety, employers' associations, and managers. A package of information on health promotion was prepared and disseminated to 3000 major Polish companies.

* Encouraging organisational structures for health promotion in the workplace, such as a network of regional health promotion leaders. The leaders (employees of the Regional Occupational Medicine Centre and of the Epidemiological Stations) are expected to help local companies implement promotion programmes .