Mental Health and Work

ISSN :
2225-7985 (online)
ISSN :
2225-7977 (print)
DOI :
10.1787/22257985
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The costs of mental ill-health for individuals, employers and society at large are enormous. Mental illness is responsible for a very significant loss of potential labour supply, high rates of unemployment, and a high incidence of sickness absence and reduced productivity at work. In particular, mental illness causes too many young people to leave the labour market, or never really enter it, through early moves onto disability benefit. Despite these very high costs to the individuals and the economy, there is only little awareness about the connection between mental health and work, and the drivers behind the labour market outcomes and the level of inactivity of people with mental ill-health. This series contributes to filling that knowledge gap. It offers both a general overview of the main challenges and barriers to better integrating people with mental illness in the world of work, as well as a close look at the situation in specific OECD countries.
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Mental Health and Work: Denmark

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Author(s):
OECD
Publication Date :
25 Feb 2013
Pages :
128
ISBN :
9789264188631 (PDF) ; 9789264188624 (print)
DOI :
10.1787/9789264188631-en

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Tackling mental ill-health of the working-age population is becoming a key issue for labour market and social policies in OECD countries. OECD governments increasingly recognise that policy has a major role to play in keeping people with mental ill-health in employment or bringing those outside of the labour market back to it, and in preventing mental illness. This report on Denmark is the third in a series of reports looking at how the broader education, health, social and labour market policy challenges identified in Sick on the Job? Myths and Realities about Mental Health and Work (OECD, 2012) are being tackled in a number of OECD countries. It concludes that the Danish system has a number of strengths that have yet to be used in a more effective way, but also that quite a few changes are needed in order to raise the labour market particiption of people with mental ill-health.

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    Foreword
    Tackling mental ill-health of the working-age population is becoming a key issue for labour market and social policies in many OECD countries. It is an issue that has been neglected for too long despite creating very high and increasing costs to people and society at large. OECD governments increasingly recognise that policy has a major role to play in improving the employment opportunities for people with mental ill-health, including very young people; helping those employed but struggling in their jobs; and avoiding long-term sickness and disability caused by a mental disorder.
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    Acronyms and abbreviations
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    Executive summary
    Throughout the OECD, mental ill-health is increasingly recognised as a problem for social and labour market policy; a problem that is creating significant costs for people, employers and the economy at large by lowering employment, raising unemployment and generating substantial productivity losses. Danish policy makers see the need for stronger action to prevent people from dropping out of the labour market due to mental illness and help those with a mental disorder to find sustainable jobs. Denmark is in a good position to tackle the challenges of mental ill-health, as it can build upon a number of system strengths. These include, for example, a good municipal structure for following up on youth at risk as well as for providing employment services to everyone in need of help. It also has an accessible health system that widely reimburses psychological therapies. Nevertheless, change is needed in order to improve the situation significantly. Changes should include a better implementation of existing regulations and more generally a stronger focus on mental health in current health, social and labour market policies and ongoing welfare reforms.
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    Assessment and recommendations
    Mental ill-health costs the Danish economy around 3.4% of GDP every year through lost productivity, social benefits and healthcare, and poses increasing problems for the well-functioning of social and labour market policies. A few years into the Great Recession, the situation in Denmark is now characterised by a concurrence of high unemployment and high disability. Importantly, the share of mental disorders is very high among both unemployment and disability benefit claimants – at 30% and 45%, respectively – and even higher among people receiving a social assistance or long-term sickness benefit (55% and 70%, respectively). At the same time, people with a mental disorder face a considerable employment disadvantage, with a gap in employment rates of around 15 percentage points and an unemployment rate which is double the overall rate. On top of this, a large share of those who are employed struggle in their jobs, with four in five workers with a mental disorder reporting occasional reduced productivity at work compared with only one in three workers without such disorder.
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    Mental health and work challenges in Denmark
    This chapter discusses the current labour market performance of people with a mental disorder in Denmark compared to other countries in terms of their employment and unemployment situation, with a view on sickness absence and reduced productivity of those working. Building on the findings in the 2011 OECD report "Sick on the Job?" it highlights the key challenges ahead, such as the high share of people on different social benefits who suffer from a mental health condition. The chapter also provides a description of the Danish benefit system and Danish employment policy and discusses the role of different levels of government.
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    Young Danes and their transition into the labour market
    This chapter assesses the capacity of the Danish system to help vulnerable youth with common mental disorders enter the labour market. It first discusses strategies to prevent mental health problems in schools and the effectiveness of school services in dealing with mental disorders. Then the chapter reviews policies directed at identifying problems among early school leavers who are at a greater risk of developing a mental disorder. It also examines the effectiveness of employment programmes to boost labour demand for vulnerable youth and addresses the problem of early labour market exit through disability benefit.
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    Flexicurity, productivity and the Danish work environment
    This chapter looks at the role of employers, who are ideally placed to help people in the workforce to deal with mental health problems and retain their jobs. It first describes the impact of negative attitudes towards workers with a mental disorder and the link between working conditions and mental ill-health. It then discusses prevention and early-intervention-at-work strategies to address challenges in the psychosocial work environment. Finally, it looks at employer responsibilities and incentives to tackle sickness absence of the workforce and the involvement of doctors in this process.
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    Sickness, unemployment and return to work in Denmark
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    Tackling labour market exit in Denmark due to disability benefit
    This chapter looks at the role and functioning of the Danish disability benefit system, the pathway through which people leave the labour market permanently, due to reasons of disability and mental ill-health. It discusses why the system, despite a large number of reforms over the past decade, continues to draw so many people into inactivity; and what was needed to change this. The chapter has a particular focus on assessment and reassessment aspects, and reflects on the potential of forthcoming reform.
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    The interface between the health and the employment systems
    This chapter discusses the effectiveness of the mental health care system in Denmark in providing adequate treatment to persons with common mental disorders, subsequently looking at the challenges for and resource capacity in primary health care and the accessibility of specialist mental health care services. It reviews the links between general and specialist care and recent policy initiatives to improve co-ordination between, and integration of, the mental health care system and the employment system.
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