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Demystifying occupational mental health
The World Health Organization (WHO) defines mental health as ‘a state of well-being in which an individual realises his or her own abilities can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.’
This broad definition explicitly acknowledges the importance of work, which provides us with a daily structure, a network of relationships, an element of psychological containment and opportunities for self-realisation and fulfilment. The workplace can promote good mental health, pose stresses that may affect individuals’ mental health and can be affected by mental ill-health.
Mental health is not just an absence of disease, and can instead be seen as a continuum, with individual having an optimum level of health. However, when an individual experiences subjective symptoms or demonstrates objective signs of being unwell, a pattern may emerge suggesting mental ill-health. These patterns are used by experts to diagnose psychiatric conditions according to internationally-recognised systems. These are: The ICD-10 (International Classification of Diseases, WHO 10th edition); or the DSM-V (Diagnostic and Statistical Manual APA 5th edition).
The value of a diagnosis is that it is standardised, specific and may help towards considering prognosis (likely outcome) and treatment options. Note that the vague and pseudo medical terms ‘stress’ and ‘depression’/’anxiety’ are not diagnoses and do not help to clarify these points. While diagnoses are useful, they are also limited in that they don’t explain why a particular individual has become unwell at this time, why the illness has taken this particular shape, and what person-specific factors may help or hinder a recovery. To answer those questions, comprehensive formulation is needed.
Employers have an important role in promoting good mental health at work. They may require specialist clinical and in some cases, legal advice to effectively deal with mental ill- health-related situations. For a given employee this may involve dealing with sickness absence/return to work and performance/disciplinary matters, reasonable adjustments and workplace or specialist support.