Mental Health in the Workplace.

Health has traditionally been defined as the absence of an obvious illness or disease, however this view of health and wellness is parochial and does not necessarily consider the human as an entity with a mind, emotions, intellect and a physical body. Health seen in its proper context entails the ability to fully function as a member of a community.

This view of health is incorporated into the WHO definition of Mental Health as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

There exists a complex relationship between work and health— work is good for mental health and also the capacity to work productively is a function of good emotional well-being. While a good work environment enhances a person's overall well-being, a negative work environment where employees are exposed to bullying, harassment, poor managerial and communication practices, inadequate financial rewards, low employee support, inflexible work hours, etc adversely impacts physical and mental health.

Unemployment is a well known risk factor for mental health problems while work is protective—by providing financial rewards, giving us self esteem, social contacts and support, a sense of achievement and status, etc. ; however, working in a negative work environment is a risk factor for substance abuse, depression, anxiety disorders, burnout, absenteeism from work, low productivity, etc. Conversely, workplaces that promote mental health and support people with mental health challenges greatly reduce employee absenteeism, increase productivity, enhance satisfaction among workers and increase economic gains.

Mental Disorders like depression and anxiety are among the most frequent causes of occupational disability; depression and anxiety have a significant economic impact; the estimated cost to the global economy is US$ 1 trillion per year in lost productivity. Depression is expected to be the second most common disorder across the world behind ischaemic heart disease by 2020 and is expected to account for 15% of the total disease burden.

There are many workplace factors that not only precipitate illness but also perpetuate disability associated with mental illness. Workplace Stress is key among these factors and it has been defined by the WHO as "a pattern of physiological, cognitive and behavioural reactions to some extremely taxing aspects of work content, work organisation and work environment".

Workplace stress has deleterious effects on both physical and mental health and has been recognised as a significant cause of absenteeism. It is a major risk factor for exhaustion, anxiety, depression and substance abuse.

Workplace stress results either from a demand-control imbalance where the level of demand on the employee is high and the control they can exert on the job is low or an effort-reward imbalance where there exists a disparity between the effort expended on the job and the reward that comes to the individual —in terms of financial rewards, esteem, prospects of promotion, job security, etc.

Stressors in the workplace oftentimes exist in both of these models and they include job insecurity, hazardous working conditions, the threat of violence, unrealistic deadlines, inflexible work hours, lack of managerial support and retribution from complaints procedures, poor remuneration, etc.

Other factors that are important in workplace mental health include bullying and psychological harassment, discrimination, stigmatization of people with mental health challenges, high and unrelenting workload especially in persons who work as first responders in emergency situations, poor team cohesion, inadequate work-life balance, etc.

According to the Article 23 of the United Nations Declaration of Human Rights, 'Everyone has a right to work, to free choice of employment, to just and favourable conditions of work and to protection against unemployment.' As such, persons, organizations and government have the responsibility to ensure that workplaces are safe, healthy and enhance mental health rather than impair it.

A healthy workplace can be described as one where workers and managers actively contribute to the working environment by promoting and protecting the health, safety and well-being of all employees. While there is no one-size-fits-all blueprint for a mentally healthy workplace because every workplace is different —the people, the work done, leadership and management styles, cultural norms and practices that obtain, etc; there are general principles and interventions that help promote workplace mental health.

Mental health strategies should be provided as part of an integrated health and well-being paradigm that covers prevention, early detection and prompt treatment, rehabilitation and continual support.
According to a report from the World Economic Forum, mental health interventions in the workplace should adopt a three-pronged approach —firstly, protect mental health by reducing work related risk factors, secondly promote mental health by developing positive aspects of work and employee strengths and lastly, address mental health issues regardless of cause.

Some strategies that positively impact mental health in the workplace include: encouraging active employee participation and decision making, clearly defining employees’ duties and responsibilities, promoting work-life balance, encouraging respectful and non-derogatory behaviours, managing workloads, allowing continuous learning, having conflict resolution practices in place and recognizing employees’ contributions effectively.

Businesses and other enterprises should actively promote appreciation of employees and workers, creation of a workplace environment that is supportive, identification of early signs of burnout, creation of an organizational culture which reflects value systems and beliefs, building awareness and reducing stigma.

Also, organizations have the responsibility to support individuals with mental disorders in either continuing or returning to work and here, there is need for innovative and compassionate thinking. Some of the strategies highlighted above will be useful in particular, flexible hours, job-redesign, addressing negative workplace dynamics, and supportive and confidential communication with management can help people with mental disorders continue to or return to work.

In the workplace, access to treatment must also be provided in a context devoid of stigmatization or discrimination. The UN Convention on the Rights of Persons with Disabilities (CRPD) provides a legally-binding global framework for promoting the rights of people with disabilities (including psychosocial disabilities). It recognizes that every person with a disability has the right to work, should be treated equally and not be discriminated against, and should be provided with support in the workplace.

In conclusion, the interaction between workplace and mental health is a complex one— adverse work environments are associated with an increase in the prevalence of psychological problems and mental disorders and common mental disorders negatively impact productivity,financial gains, job satisfaction, etc.

Workplaces that adopt good mental health practices and policies are more likely to increase productivity, reduce absenteeism and as a result benefit from the associated economic gains while also boosting staff morale, employee satisfaction, creativity and loyalty to the organization.


World Health Organization's Mental Health in the workplace Information Sheet. Sept 2017

Prem Chopra: Mental Health and the Workplace: issues for developing countries. International Journal of Mental Health Systems 2009 3 :4

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Murray CJL, Lopez AD: The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries, and risk factors in 1990 and projected to 2020. 1996, Cambridge: Harvard School of Public Health Google Scholar


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