mental health and employment

mental health and employment
Mental health problems often cause fatigue and impaired attention, concentration and poor memory (Scheid, 2005; Lerner et al., 2004; Mancoso, 1990). These problems can be compounded by the effects of medication. However, ‘functional impairment’ at work is less common than ‘affective impairment’ such as emotional distress (Mintz et al., 1992) and there is only a weak association between the objective level of severity of a mental health problem and its impact on function at work (Dion et al., 1988; Tohen et al., 2000). Despite this, one large study found that depression has a greater negative impact on time management and productivity than any other health problem and is equivalent to rheumatoid arthritis in its impact on physical tasks (Burton et al., 2004). The problems caused by mental ill health can be a particular barrier to both high status jobs and those where there are high levels of contact with the public (Scheid, 2005).
Mental health problems are a major cause of presenteeism which is where an
employee is unwell and remains in work but is less productive. As discussed in
section 1.5, as much as 60% of the employment related costs of mental illness
are due to presenteeism (Sainsbury Centre for Mental Health, 2007). This might
be because people with mental health problems lack obvious outward signs
and are reluctant to have to ‘prove’ they are ill because of the resulting stigma.
Figure 1 is a simplified representation of the complex path from being well to being long term sick. Many factors, including individual perceptions, beliefs and decisions, contribute to mov ement up and down the path and each step is not an unavoidable consequence of the preceding one. It is far from clear why certain employees develop symptoms at work or, having developed symptoms, attribute them to work. The nature of the work environment appears to be an independent risk factor for the development of symptoms in those in work, and, to some extent in predicting which employees with symptoms will take time off. At this point however, individual factors such as coping style become important. Beliefs and expectations of recovery are more prominent risk factors in those who are already off work, and common mental disorders are strong predictors of extended sick leave.