Landmark publication offers a global picture of the work-related causes of mental health conditions

A landmark scientific article on the workplace as a major determinant of health is published today (Thursday, 12 October) in The Lancet, and reveals a global picture of the work-related causes of mental health conditions.

Carried by University College Cork (UCC) researchers for the Lancet Series on work and health, the paper illustrates that major progress in population health can be made by an increased focus on improving people's work environments.

The paper, 'Work-related causes of mental health conditions and interventions for their improvement in workplaces', presents sound epidemiological evidence based on large-scale international cohort studies that adverse working conditions contribute to an increased risk of onset of depressive disorders and outlines critical interventions to improve mental health conditions in workplaces.

Dr Birgit Greiner and Professor Ella Arensman, UCC School of Public Health, co-authored the article with academics from universities in Europe, Japan and Australia. Dr Birgit Greiner will present the findings at the World Health Summit in Berlin on Sunday, 15 October.

Mental health problems and mental disorders are common

The report finds that mental health problems and mental disorders are common in the working population. Researchers cite that 15% of adults of working age experience mental health disorders, with depression, anxiety and substance abuse being the most common.

Workers with mental health disorders are at increased risk of sickness absence, unemployment, permanent exit from employment, and lower lifetime income, which in turn can exacerbate mental disorders. Mental disorders incur substantial costs for workers, employers and the whole of society.

The article finds that most interventions focus on the individual level only and recommends that more proactive interventions need to be developed to protect and promote workers' mental health and wellbeing.

Ahead of her address at the World Health Summit, Dr Birgit Greiner said: "We know mental health problems and disorders are common in our working population. Workplaces have huge potential to influence mental health by promoting the positive aspects of work and providing safe, non-discriminatory support for those showing signs of mental health problems. Modifying psychosocial working conditions is key. Workplace mental health should be made a collective concern at all levels of an organization."

Professor Ella Arensman, Head of School of Public Health UCC and Chief Scientist, National Suicide Research Foundation, said: "Work-related mental health is an issue of society and public health importance. We know burnout and distress are common particularly within the healthcare sector, leading to difficulties in attracting new workers, their retention and turnover. Interventions must include the prevention of mental health problems along with helping affected individuals regardless of cause. They must also include the pro-active promotion of positive mental health, wellbeing and recovery."

Key recommendations

The report outlines recommendations for decision-makers to support healthy and safe work for diverse populations. Key recommendations include:

• Governments need to ensure that the workplace is an integral part of their mental health strategies.
• Policymakers at local, national and international levels need to regulate and control working environments-;evidence suggests an increased risk of mental health problems and mental disorders in adverse conditions.
• Policymakers should develop and improve policy on mentally healthy work, with a particular focus on the work environments of low-wage or marginalized workers.
• Policymakers need to develop guidance on how to create and maintain mentally healthy work at all levels of an organization-;this includes promoting training programmes.
• Governments should improve support and workplace conditions to enable individuals with mental health problems and disorders to be part of the workforce.
• Healthcare providers should routinely include information on working conditions in the clinical assessment, diagnosis and management of mental health problems and mental disorders.

Workplace mental health promotion practice and policy gained a lot of traction in many sectors during the past few years. Several large organizations implemented Employee Assistance Programmes and Peer support systems to offer support for those with mental health problems. Organizations now need to take a second step and augment these programs with proactive initiatives to improve work organizations and working conditions. This is not just a moral imperative but necessary for employers to meet legal and ethical mandates on psychologically safe work environments."

Professor Ella Arensman

The above-mentioned recommendations are currently being investigated in the ongoing EU Horizon 2020 MENTUPP project: Mental Health Promotion and Intervention in Occupational Settings and the new EU Horizon Europe PROSPERH project: Promoting Positive Mental and Physical Health at Work in a Changing Environment – A Multi-level Approach, led by the UCC School of Public Health and the National Suicide Research Foundation..