Mental health and employment: An overview of patterns and policies across Western Europe

Background: The relationship between mental health problems and employment is receiving growing attention across Europe as the cost of lost productivity is appreciated. Aims: This paper reports on the preliminary collection of data on employment of people with mental health problems and related economic issues in 17 countries participating in the Mental Health Economics European Network (MHEEN). Method: A questionnaire was developed with the Network partners and statistical and narrative data collected. These local and national level data were examined for patterns and trends. Results: Across Europe, the impact of mental health problems on lost productivity is substantial and growing. A range of policies have been developed to address this challenge, covering the spectrum of issues from workplace interventions promoting positive mental health to anti-discrimination laws to enable participation in the workforce. Conclusions: While much is being done, data and information on best practice across Europe are scarce. There is a need to share and collect this information to facilitate the sharing of best practice in Europe

Moving beyond the mental health care system: An exploration of the interfaces between health and non-health sectors

Background: Many interventions both to promote good mental health and to tackle the consequences of poor mental health may be funded and/or delivered outside the health care sector. Aims: To describe the interfaces between health and other sectors, particularly social care, in 17 European countries, and to look at potential ways in which challenges to the efficient and fair delivery of services across sectors may be overcome. Methods: A structured questionnaire was completed by partners in the Mental Health Economics European Network (MHEEN) to review the extent to which mental health related services are funded and delivered outside the health care sector, with a particular emphasis on social care services. This was augmented by a review of the literature. Results: The boundaries between health and other sectors differ across and within countries. The provision and funding of services may be highly fragmented and poorly coordinated, with little incentive for funding to follow individuals along the care pathway. Out-of-pocket payments for non-health sector services can be substantial and much responsibility may fall to families. Conclusions: Differing rules of entitlement, as well as fragmentation and poor coordination between health and non-health services can act as barriers to a truly holistic approach to mental health across Europe. Useful insights on how to overcome some of these barriers may be drawn from experiences of joint working and innovative financing arrangements in respect of older people and those with physical disabilities. However as yet there have been comparatively few attempts to smooth the sector interfaces that confront those with mental health needs