Impact assessment of mental health on employment

This study examined the obstacles and shortcomings faced by people with mental health problems when at work or trying to find work. Perceptions of people with mental health problems are rather negative. A lack of flexibility, absence of suitable training programmes, stigma and discrimination can hamper those with mental health problems from finding and retaining employment. Recommendations are made on how to create work environments that take account of their needs.

About the study

The study, Impact assessment of mental health on employment for policy development (IAMHE), was partly funded by the European Social Fund to obtain a better understanding of the main obstacles that affect the access, integration, retention and progression at work of those with mental health problems.

The study, which took place in Malta and Gozo during 2009 and 2010, was carried out on behalf of the Richmond Foundation – a non-governmental organisation (NGO) offering community services to those with mental health problems – working in partnership with the Employment and Training Corporation (ETC), Malta Employers’ Association (MEA) and Compagnie de Sporen (Ghent, Belgium).

Methodology

This study included both quantitative and qualitative research. The quantitative part included a self-reporting survey carried out in 2010, which was based on 591 replies from respondents who were either employed or self-employed. The survey sought to capture their perceptions and awareness on issues relating to mental health problems at work.

The survey sample was taken using clustering sample techniques to select households. The sample also included informants who wished to be employed but were facing hurdles in gaining employment. This included people who were experiencing mental health problems and others who had caring responsibilities (of children or elderly relatives). Certain questions were only asked of the 36 respondents who indicated that were experiencing mental health problems or who had experienced them in the past.

The qualitative research included:

• a focus group with policymakers and other stakeholders;

• 17 in-depth interviews with people who had mental health problems;

• three interviews with employers who had direct experience of workers with mental health problems.

Following the in-depth interviews, two other focus groups were set up to discuss the findings with the informants. One was a focus group made up of people with mental health problems and the other was made up of stakeholders and policymakers.

Main findings

Stress at work

Just over 20% of respondents claimed that work had caused them some form of emotional or mental health problems, including anxiety and depression in a minority of cases. The study found that:

• stress is affected by the number of hours worked, with 71.5% of those who worked for 60 hours a week considering their job to be either ‘stressful’ or ‘very stressful’;

• 36% of employees tended to work over 40 hours a week;

• those who were self-employed put in more hours than those who were employed.

Due to stress or burnout in the last five years, 10.5% of respondents had to take leave of absence as a result. In the majority of cases (75%), the leave lasted up to one week, but in 10.5% of cases, the leave taken was for longer periods of time.

Understanding of mental health problems

Although the vast majority (92%) of respondents believed that anyone is susceptible to mental illness, perceptions of people who are mentally ill were rather negative with:

• 60% of respondents claiming that those with mental health problems can be unpredictable and violent;

• 54% believing that such people are ‘more dangerous by far than the general population’.

In the workplace, people with mental health problems are avoided to some extent and, in some cases, they are ridiculed or discriminated.

Despite these negative perceptions, 77% of respondents agreed that those with mental health problems can be cured and can return to their normal lives if they receive professional help. Some 44% of respondents felt that people with mental health problems can perform their tasks well, but 32% felt that they could only do so occasionally.

Prevalence of mental health problems

Some 24% of those respondents who worked or who were willing to work claimed that they had experienced symptoms of mental or emotional health related problems. Of these, 72.5% had been professionally diagnosed by a medical doctor, psychologist, psychiatrist or a combination of these three, and 20.5% were unaware of the name of their illness. In the majority of cases they had been diagnosed as having problems related to anxiety (29.5%), stress (26.9%) or depression (24.4%).

Barriers to employment

Findings from the qualitative part of the study suggest that people with mental health problems feel less confident at work, possibly due to the fear of stigma and discrimination. They claimed that those experiencing mental health problems normally need flexibility in their working hours, and when this was not offered, it discourages them from finding work. Lack of training also hindered such workers from obtaining work and remaining in employment.

Among employers, there seemed to be a lack of awareness on how to deal with workers presenting mental health problems. Awareness and understanding were also low among the general public.

Commentary

Work is fundamental to improving the quality of life of people with mental health problems. However, such people need to be able to work without fear of stigma, discrimination or prejudice. This means that everyone should be aware of their legal rights. Avoidable risks and causes of stress need to be reduced in order to create healthier workplaces that also offer flexible work arrangements.

Among other things, the final study report suggests that training, advice and support services – including a helpline – are offered to employers, human resource managers and line mangers to assist them in dealing with employees who have mental health problems. The report also recommends that those with mental health problems are offered individual coaching and are supported at work.

Reference

Richmond Foundation (2011), Impact assessment of mental health on employment for policy development, Malta [main research report].

Anna Borg, Centre for Labour Studies