In the EU Framework Directive (89/391/EEC) (1989) the European Union recom-mended a holistic approach towards employees’ well-being at work, that takes psy-chological well-being as well as physical health strongly into account in occupational safety and health policy. The responsibilities of employers and employees regarding Health and Safety at Work are clearly outlined. The Member States have transferred this aspect into their national occupational safety and health laws in order to tackle the humanisation of work and to promote mental health at work.
Although the following figures quoted from the WHO ‘World Health Report 2001’ do not exclusively focus on mental health at work, they are worth mentioning, since they demonstrate the topicality of mental health issues. The figures indicate that mental health policies are in place in 63% of 181 Member States, and 96% out of 160 Mem-ber States have mental health legislation. The efforts put into developing policies and legislation are crucial, since according to a European-wide study, 17% of the
popula-82
tion in Europe suffers from mild or severe depressive disorders (Gastpar, 2002).
Furthermore it has been estimated by the European Agency for Safety and Health at Work, that work-related stress costs approximately 20 billion Euro across Europe, in terms of lost time and health costs.
It can therefore be seen as a positive trend that the number of enterprises setting up activities to promote and prevent mental (ill) health has increased significantly over the last decade. There are several reasons why the interest particularly in Workplace Health Promotion is greater than ever. Some are mentioned here:
· The high costs due to sick leave and short-term absenteeism incurred for enter-prises and for society as a whole and also for individuals suffering from disability, are one of the reasons for health promotion activities in this field. - The WHO re-ported that about 450 million people world-wide are affected by mental neurologi-cal or behavioural problems at any given time (approximately 121 million people suffer from depression, WHO, 2001). Workplace Health Promotion is on the agenda in many enterprises not only to save costs but also to improve the overall image of the organisation. They have recognised that managing their human capital is at least as important as managing their financial and other resources.
Employees’ health is seen to be a key factor in any organisation in achieving greater effectiveness, competitiveness and productivity. The relevant keywords are: ‘Business excellence’ – value through people. Overall business excellence depends entirely on human capital, but can only be achieved together with ‘men-tal health excellence’. This in turn is only possible if it becomes a management priority.
· Because people spend at least one third of their life at work, the workplace is an ideal setting to reach them with information and assistance and to help them to improve their own health and well-being at the workplace.
· The existing occupational health and health & safety structures in the workplace facilitate the provision of mental health promotion activities for the employees.
The First International Conference on Health Promotion was held in Ottawa, Canada in 1986. Health Promotion was clearly defined as a process which enables
individu-als to enhance control over and to improve their health. To achieve a state of total physical, mental and social well-being, an individual has to be able to identify and to recognise goals, to satisfy needs, and to cope with change or with the environment.
Therefore Health is seen as a resource to cope with daily life and not as one of life’s objectives. health is a positive concept accentuating social and personal resources, as well as physical abilities. Health promotion focuses on reducing the differences in health status and should guarantee equal opportunities and resources to everyone in achieving their maximum health potential. This calls for a supportive environment, access to information and life skills as well as the possibilities for making healthy choices. The aims set out in the Ottawa Charter reflecting the Public Health Perspec-tive were reinforced and adapted to the working environment in a common European definition on Workplace Health Promotion, developed by the members of the Euro-pean Network Workplace Health Promotion (ENWHP) in the so-called “Luxembourg Declaration”:
“Workplace Health Promotion (WHP) is the combined efforts of employers, employees and society to improve the health and well-being of people at work.
This can be achieved through a combination of:
· improving the work organisation and the working environment
· promoting active participation
· encouraging personal development”
(Luxembourg Declaration, 1997) 10
These principles apply as well to mental health promotion at work. Mental health promotion is indeed part of any health promotion activity at work. Unfortunately this is often not clear enough. Depression evidently has a huge impact on mental and physical well-being (Goetzel et al., 2002). Results of various studies show for exam-ple, that individuals although not suffering from heart disease but prone to depression are four times more likely to be at risk of having a heart attack than those not suffer-ing from depression. It was also observed, that depressed workers have a chronic increase in the concentration of stress hormones in the blood (e.g. cortisol,
10 http://www.occuphealth.fi/ttl/projekti/whp/luxdec.html
84
line), since they trigger the sympathetic nervous system and may account for coro-nary artery disease.
In Tampere in 1999 the Finnish Minister of Health Ewa Biaudet stated that “There is no health without mental health”. This was the key message at the European Confe-rence on Promotion of Mental Health and Social Inclusion. It also applies to the workplace: There is no workplace health without mental health.