Mental health policy and practice across Europe: an overview

296 Mental health policy and practice
well-being is moderated by a number of important factors. These include the
level of social support at work, the coping style of the individual worker, the
occupational grade of the worker and socioeconomic status.
Stress at work has been demonstrated to be related to a number of indicators
of mental well-being. These include symptoms of anxiety, depression and various
elements of mood. At its most extreme, where stress can be characterized as
severe and traumatic, post-traumatic stress disorder may result.
Of course, stress generally and occupational stress in particular may impact
on other aspects of well-being apart from mental health – there are well
demonstrated relationships with a range of physical health measures (e.g. the
cardiovascular system, the digestive system, the immune system, and the
endocrine system) and with a range of workplace indicators such as ‘on the job’
performance, job satisfaction, absenteeism and workforce morale.
Workplace interventions for occupational stress
Stress at work is a multi-dimensional phenomenon with implications for both
the individual in terms of health, well-being and work performance, and for the
workplace in terms of the organization of work, levels of performance at work
and ultimately such indicators as absenteeism and productivity. The multifaceted
nature of the problem can lead to interventions in the workplace which
have been designed for multiple purposes – they may, for example, simultaneously
seek to improve the organization of work as well as improve the
health and well-being of the individual. Equally, interventions which are
designed to address only one aspect of the problem may have effects on other
areas. This point is important, as most interventions are designed for reasons
other than the improvement of mental health (e.g. to meet health and safety
requirements, to reduce absenteeism figures, to improve productivity). However,
because of the inter-relatedness of the effects of stress, such interventions
may have positive effects on mental health.
Interventions for dealing with stress may be broadly categorized as workeroriented
and workplace-oriented. In addition, they may also be categorized
on the basis of whether they are primary, secondary or tertiary in their focus.
Table 12.1 describes some of the major interventions that may be made using
this categorization.
In theory, workplace interventions to ameliorate stress and improve mental
health should include activities at all three levels, and should also address both
the workplace and the individual worker. However, in practice it is relatively
rare to find such integrated interventions, and most are still directed at the
worker and are often only secondary or tertiary in nature (Van den Bossche
and Houtman 2003). However, more comprehensive approaches have been
described (e.g. see Kompier and Cooper 1999).