Policy Documents | ENMHP

Edinburgh Declaration on Mental Health Promotion

Tilia Bousios — Tue, 26 Oct 2010 11:16:00 GMT

The Edinburgh Declaration on Mental Health Promotion has been produced by the European Network for Workplace Health Promotion in October 2010. It aims to draw attention to the need to promote mental health and well-being at work by the Social Partners and other stakeholders. It envisages that 10 actions can be taken to promote workplace mental health and well-being.

The Edinburgh Declaration on Mental Health Promotion has been produced by the European Network for Workplace Health Promotion in October 2010. It aims to draw attention to the need to promote mental health and wellbeing at work by the Social Partners and other stakeholders. It envisages that 10 actions can be taken to promote workplace mental health and wellbeing. These include:

Providing meaningful and stimulating work and supportive work organisation
Providing opportunities for employee skill development
Promoting greater employee participation in decision making.
Recognising the key role of managers in supporting staff.
Creating a positive working environment with clear job roles and expectations
Reducing stress at work and promoting coping strategies
Encouraging a culture of enterprise, participation, equity and fairness, and challenging stigma and discrimination in the workplace.
Supporting, retaining and employing people with mental health problems.
Developing strong policies on mental health and wellbeing
Monitoring the impact

Living Conditions, Social Exclusion and Mental Wellbeing – Second European Quality of Life Survey

Argyro Kazaki — Fri, 15 Jan 2010 17:36:43 GMT

The European Quality of Life Survey (EQLS) was conducted by the European Foundation for the Improvement of Living and Working Conditions (Eurofound) for the first time in 2003, covering 28 countries (the 15 EU Member States, 12 forthcoming Member States and Turkey). Eurofound’s second wave of the EQLS, which was carried out in 2007, offers a wide-ranging view of the diverse social realities in 31 countries – the current 27 EU Member States, along with Norway and the three candidate countries of Croatia, the Former Yugoslav Republic of Macedonia and Turkey. Many of the questions posed in the first EQLS in 2003 were asked again, on issues such as employment, income, education, housing, family, health, work–life balance, life satisfaction and perceived quality of society. In 2008, Eurofound commissioned secondary analyses of the EQLS data around key policy themes. The selected themes for the first set of secondary analyses are the following: trends in quality of life in Europe 2003–2008; living conditions, social exclusion and mental well-being; family life and work; subjective well-being; and quality of society and public services. This analytical report focuses on the theme of living conditions, social exclusion and mental well-being. It draws on the results of the EQLS to examine the factors that influence perceived social exclusion and the impact that this has on mental well-being. Such factors include labour market access, income and lifestyle standards, and access to social support. The scope of the findings – spanning 31 countries – offers an important insight into how social exclusion and integration vary across Europe, given the different cultural and historical contexts as well as recent social and economic experiences.

Over the past two decades, there has been a major shift in the European debate regarding social progress and how it is measured. The concept of social exclusion has increasingly replaced the concept of poverty within the EU policy discussion on social vulnerability and disadvantage. Unfavourable labour market access and living conditions affect both social participation and social contact, which in turn impact on the quality of life of Europe’s citizens and influence their perception of social exclusion. This report looks at the relationships between living conditions, social exclusion and mental well-being. It draws on the results of the EQLS to examine the factors that influence perceived social exclusion and the impact that this has on mental well-being. Such factors include labour market access, income and lifestyle standards, and availability of social support. The following areas are covered in this report; Brief history and conceptual overview Perceived social exclusion and reported social contact Impact of social conditions on perceived social exclusion Social support, living conditions and perceived social exclusion Impact of living conditions and perceived social exclusion on mental well-being

Working our Way to Better Mental Health: A Framework for Action

Argyro Kazaki — Mon, 04 Jan 2010 12:12:00 GMT

Mental ill-health presents a major challenge to the well-being of our society, and the strength of our economy. It blights lives, traps people in poverty and prevents the country harnessing the talents and potential of hundreds of thousands of people. Government is determined to lead the way in meeting this challenge. Poor mental health is very common. At any one time, one in three of our working-age population may be experiencing some kind of distress or mental health condition such as depression. The vast majority, fortunately, will recover quickly. But for far too many, the result is a lengthy sickness absence or long-term unemployment. Indeed mental ill-health is now the most common reason for claiming health-related benefits and 86 per cent remain on the benefits for more than three months (compared to 76 per cent for all other claimants). And the evidence shows that the longer people are detached from the labour market, the less chance they have of returning to work. This is even more of a risk when, as now, global economic problems are pushing up jobless figures around the world. We have learnt from past recessions of the real danger of short-term job loss turning into permanent unemployment and are determined not to repeat these mistakes. The positive link between employment and mental health is absolutely clear. Research shows people generally enjoy better mental health when they are in work. In contrast, the longer individuals are absent or out of work, the more likely they are to experience depression or anxiety. Work can therefore play a vital role in improving everyone’s well-being and mental health. Of this we estimate around one third - £30-40 billion – can be attributed to mental ill-health, in lost production, and National Health Service (NHS) treatment. And it does not count the additional and hidden cost of people with mental health conditions still in jobs but working beneath their full potential. A modern economy cannot afford such waste of individual talent nor the high welfare costs. We are determined to step up our efforts to support people in work and to help those out of work to return quickly to fulfilling and rewarding employment.

This document establishes a cross-government approach to tackling this cost and waste. It has been developed with the support of Dame Carol Black, the National Director for Health and Work, who consulted mental health specialists, senior academics, representatives from business and third sector organisations, as well as people with mental health conditions. The framework for action has a dual approach. It is designed to:

Improve well-being at work for everyone; and
Deliver significantly better employment results for people with mental health conditions, supporting then into work, helping them to stay in work and assisting them to return to work more quickly after sickness absences.

This is a challenging agenda – made even more so by the current economic conditions. But the Government believes the economic climate makes it even more important to step in to help people through new and effective solutions. The framework identifies six key areas where action is vital to achieve our goals. They are:

Action to change attitudes to mental health. • Action to improve health and well-being at work for the whole population.
Swift intervention when things go wrong. • Co-ordinated help tailored to individuals’ needs both in and out of work.
Action to build resilience from early years and throughout working lives.
Co-ordinated action across government to ensure we deliver success. Action on employment and mental health must be a long-term commitment.

The wider aim of this comprehensive programme for action is to influence future policy development across governments, departments and throughout the wider public sector, and bring about changes in behaviour in organisations and individuals. And it is designed to build a long-term commitment to joint working between Government and its partners. Together we can work our way to better mental health.

Promoting Mental Wellbeing through Productive and Healthy Working Conditions: Guidance for Employers

Argyro Kazaki — Thu, 03 Dec 2009 12:08:00 GMT

The Department of Health (DH) asked the National Institute for Health and Clinical Excellence (NICE) to produce public health guidance on promoting mental wellbeing through productive and healthy work. The guidance is for those who have a direct or indirect role in, and responsibility for, promoting mental wellbeing at work. This includes all employers and their representatives, irrespective of the size of the business or organisation and whether they are in the public, private, or voluntary sectors. It may also be of interest to professionals working in human resources or occupational health, employees, trade unions representatives and members of the public.

The guidance complements, but does not replace, NICE guidance on workplace promotion of physical activity and smoking cessation and also on depression. The Public Health Interventions Advisory Committee (PHIAC) developed these recommendations on the basis of reviews of the evidence, an economic analysis, expert advice, stakeholder comments and fieldwork. The guidance was developed using the NICE public health intervention process.

SLAN Survey of Lifestyle, Attitudes and Nutrition in Ireland - Mental Health and Social Well-being

Argyro Kazaki — Tue, 03 Mar 2009 08:43:46 GMT

This report presents the main findings on the mental health and social well-being of Irish adults from the 2007 Survey of Lifestyle, Attitudes and Nutrition (SLÁN 2007). The SLÁN 2007 survey, commissioned by the Department of Health and Children, involved face-to-face interviews at home addresses with 10,364 respondents (62% response rate), aged 18 years and over; full details are given in the SLÁN 2007 Main Report (Morgan et al, 2008). This sample was representative of the general population in Ireland and was further weighted, for the purpose of analysis, to match the Census 2006 figures. SLÁN 2007 is, therefore, the largest national survey to date on the extent of both positive and negative mental health and social well-being in the Irish adult population. This report presents the findings on mental health and social well being, and considers the influence of key socio-demographic variables, including age, gender, social class, education, income, residential location, employment status and marital status. The relationships between mental health, social well-being, self-rated health and selected health behaviours from the main survey are also examined. The study aims to determine the levels of mental health in the Irish adult population, including positive mental health, psychological distress, major depressive disorder, generalised anxiety disorder, reported self-harm and perceived stigma. The survey also evaluates the levels of social well-being in the Irish adult population, including levels of quality of life, social support, loneliness, community involvement and neighbourhood perceptions.

Dame Carol Black’s Review of the Health of Britain’s Working-Age Population – Summary of Evidence Submitted

Argyro Kazaki — Wed, 25 Feb 2009 09:45:01 GMT

In 2007, the Secretaries of State for Health and for Work and Pensions commissioned the National Director for Health and Work, Dame Carol Black, to undertake the first ever review of the health of Britain’s working age population. Dame Carol announced a Call for Evidence at a round-table event with leading business and medical professionals in October 2007. This was held in London and chaired by the two Secretaries of State. Responses to the Call for Evidence were invited through the Health, Work and Well-being website (www.workingforhealth.gov,uk), and promoted in a variety of media at the national and regional level. They were further supplemented by six discussion events held across Britain during November 2007.

In announcing the Call for Evidence, Dame Carol posed eight questions to indicate the wide remit of the Review and provide a focus for debate. In total, 267 written responses were received from a broad range of sources, of which 152 were from various types of organisation and 115 from individuals. Organisations which responded included representative bodies (e.g. trade associations,, employers, academic institutions, medical bodies, and central and local government. Individuals who responded represented a wide range of backgrounds, including general practitioners (GP’s), OH specialists, academics and the general public. The responses varied from extensive research reports to personal experience and perspectives. Some submissions covered all eight questions and some focused only on specific issues of interest to the respondent. The proportion of responses covering specific questions varied from around 60% (keeping the working age population healthy) to about 35% (impact on poverty and social inclusion). The responses were considered by Dame Carol and analysed to inform the findings of her Review. This document summarises the evidence contained in the responses and shows how it informed the recommendations in Dame Carol’s report.

Dame Carol Black’s Review of the Health of Britain’s Working-Age Population – Working for a Healthier Tomorrow

Argyro Kazaki — Wed, 25 Feb 2009 09:44:30 GMT

Improving the health of the working age population is critically important for everyone, in order to secure both higher economic growth and increased social justice. The Review has sought to establish the foundations for a broad consensus around a new vision for health and work in Britain. At the heart of this vision are three principal objectives: • prevention of illness and promotion of health and well-being; • early intervention for those who develop a health condition; and • an improvement in the health of those out of work – so that everyone with the potential to work has the support they need to do so.

This report details how the health of the working age population can be measured, establishing a baseline. Following this, the report sets out proposals for realising the objectives listed above.

Improving Health and Work: Changing Lives. The Government’s Response to Dame Carol Black’s Review of the Health of Britain’s Working-Age Population

Argyro Kazaki — Wed, 25 Feb 2009 09:43:59 GMT

This document details the Government’s response to the Review of Britain’s working-age population, conducted by Dame Carol Black. The Government’s response is built around three key aspirations that demonstrate how they will rise to the challenges that she set and which will enable the Governments delivery of their broader version: • creating new perspectives on health and work; • improving work and workplaces; and • supporting people to work.

The Government are in agreement with recommendations made in the Review. They acknowledge that more could be done to promote the benefits of work to health for individuals, employers, healthcare professionals, society and the economy. They also recognise the need for increased employer support to ensure workplaces are healthy and safe and that they promote the well-being of employees and facilitate return to work when workers develop a health condition or impairment.

Mental Health and Work

Argyro Kazaki — Wed, 25 Feb 2009 09:43:29 GMT

The Secretary of State for Health and the Secretary of State for Work and Pensions have asked Professor Dame Carol Black, National Director for Health and Work, to lead a review of the health-related factors that influence working life in Great Britain, and make recommendations. The review will inform policy and guide action in relation to health and employment. The Review Team commissioned this supplementary report because mental health problems have a greater impact on people’s ability to work than any other group of disorders. Mental ill health affects the productivity of those in work by impairing their ability to function at full capacity and it causes about 40% of all days lost through sickness absence (Sainsbury Centre for Mental Health, 2007). It also accounts for 40% of those claiming incapacity Benefit and 23% of new claimants of Disability Living Allowance. This review investigates a number of mental health disorders as related to job performance. Return to work following mental illness is discussed, with recommendations for reducing sickness absence and the introduction of interventions. Systems, services and policies associated with mental health are also discussed in detail.

European Commission Health Strategy - 'Together for Health: A Strategic Approach for the EU 2008-2013'

Argyro Kazaki — Wed, 24 Oct 2007 10:45:00 GMT

On 23 October 2007 the European Commission adopted a new Health Strategy, 'Together for Health: A Strategic Approach for the EU 2008-2013'. Building on current work, this Strategy aims to provide, for the first time, an overarching strategic framework spanning core issues in health as well as health in all policies and global health issues. The Strategy aims to set clear objectives to guide future work on health at the European level, and to put in place an implementation mechanism to achieve those objectives, working in partnership with Member States.

The Strategy focuses on four principles and three strategic themes for improving health in the EU. The principles include taking a value-driven approach, recognising the links between health and economic prosperity, integrating health in all policies, and strengthening the EU's voice in global health. The strategic themes include Fostering Good Health in an Ageing Europe, Protecting Citizens from Health Threats, and Dynamic Health Systems and New Technologies.

Communication from the Commission to the Council and the European Parliament’: Europe’s Response to World Ageing, Promoting Economic and Social Progress in an Ageing World

Argyro Kazaki — Fri, 01 Jun 2007 10:04:00 GMT

European Commission (2002), ‘Communication from the Commission to the Council and the European Parliament’: Europe’s response to World Ageing, Promoting economic and social progress in an Ageing World, a contribution of the European Commission to the 2nd World Assembly on Ageing.

This communication constitutes the contribution of the European Commission to the 2nd World Assembly on Ageing organised in Madrid on April 8-12 2002, by the United Nations and the Spanish Government. It represents an input from the European Commission to the international debate on the new International Plan of Action on Ageing to be adopted in Madrid. As such it is intended to support the efforts of the Belgian and Spanish presidencies to develop a common EU position on the plan.

When the first International Plan of Action on Ageing was agreed in Vienna in 1982, it was almost exclusively for the most developed countries that ageing was emerging as an important concern. Since then, the ageing process has begun to touch several parts of the developing world also. In the 21st century rapid ageing will progressively become a global phenomenon. The European Commission agrees with the United Nations that a greater global awareness will be necessary in order to meet the challenges for all our societies raised by the ageing process. International co-operation can improve the ability of countries to respond to these challenges. Policies that take due account of the ageing challenges in the future have to be prepared now.

With this Communication the Commission proposes to share the experience from cooperation on ageing issues at EU level, which illustrates the need for a policy approach encompassing the economic, employment and social dimensions of ageing. The Commission is fully aware of the diversity of the ageing challenges across the world and that its experience cannot necessarily be transposed to other contexts. Nevertheless, it is convinced that its experience can be used to develop ideas. Responding to ageing issues in the world calls for a collective effort of international collaboration to promote sustainable development at global level.

The State of Mental Health in the European Union 2004

Argyro Kazaki — Fri, 01 Jun 2007 09:22:00 GMT

Report describing and comparing the state of mental health in the European Union and Norway, in the context of longstanding efforts of EU public health programmes to promote good mental health and to prevent mental ill health. The report is based on previous expert recommendations on mental health indicators, which propose that mental health should be described in three dimensions: positive mental, negative mental health, and diagnosis of psychiatric disorders.

This report aims to describe and compare the state of mental health in the European Union and Norway, in the context of longstanding efforts of EU public health programmes to promote good mental health and to prevent mental ill health. A documented knowledge of the population’s mental health status, and its determinants, is essential to establish the basis for such programmes and to monitor and improve them.

In preparing this report, it has been assumed that collecting and comparing information on mental health between countries will enable Member States to improve their understanding of mental health issues and to plan appropriate policy responses. Mental health has to be considered as a public health priority due to the heavy burden it places on the EU and its Member States.

The report’s starting point is the acknowledgement that Member States are different in terms of population density, aging, poverty levels, cultural background and habits. Furthermore, all of these factors have been shown to have some links with mental health status and some of them have been identified as risk factors. This project has involved representatives from all EU countries plus Norway, WHO Europe, a representative of a non-governmental organisation (Mental Health Europe) and a representative of OECD Europe.

Policy Brief: Health Care Outside Hospital. Accessing Generalist and Specialist Care in Eight Countries

Argyro Kazaki — Fri, 01 Jun 2007 08:48:00 GMT

The delivery of health care is changing. While the acute hospital will always play a key role in the provision of health care, reflecting its important role in training and research, as well as its capacity to manage complex and severe disorders, in many countries there is an increasing interest in the scope to transfer some types of care out of hospitals.

There are a number of factors supporting this interest:

the perceived high cost of hospital care (although in many cases the same care provided outside the hospital can be as expensive, or more so, because of the loss of economies of scale);
the challenges of delivering hospital care in the future, especially where there are dispersed populations;
the belief that moving services out of hospitals will make them more accessible, thus increasing responsiveness and, perhaps, patient choice.

Despite this interest, there is surprisingly little information currently available about how different countries deliver care outside hospitals. This is in contrast to the extensive information on topics such as the numbers of hospital beds. In this policy brief we aim to describe a broad spectrum of models by exploring the arrangements that are in place in eight countries. This is intended to provide a basis for a more informed discussion on the future of health care outside the hospital. The countries were selected to include a variation: those where health care financing is based predominantly on social health insurance (France and the Netherlands) and those whose systems are mainly funded through taxation (Australia, Denmark, England,* Finland, New Zealand and Sweden).

Public Health In Austria

Argyro Kazaki — Fri, 01 Jun 2007 08:22:00 GMT

In the general hustle and bustle and stress to which we are subjected every day, we all too often lose sight of what is most important - our health. In industrialized societies, the dominant attitude toward health was long primarily reactive. As long as someone was healthy, he or she didn’t worry, but - when illness arrived - powerful medications were called upon to restore health as quickly as possible. Recent times, on the other hand, have seen the rise of a “preventive” approach - and that is a definite step in the right direction. The newly revised informational booklet “Public Health in Austria” is a further step in this direction - it is meant to inform readers and encourage them to do something for their own health.

With the Health Care Reform Act of 2005, the Federal Ministry of Health and Women has established guidelines for preventive medicine. One of the central points is riskgroup-oriented preventive examinations. Such annual check-ups are paid for by the public insurers, making it possible to examine patients according to their individual needs. In this way, illnesses are recognized and given appropriate therapy in their early stages. Special attention is paid to the living habits of the patients (alcohol, smoking, illnesses in the family, etc.). The “new check-up”, offered free-of-charge from age 18 onward, is intended to be viewed by citizens with the same urgency as yearly inspection tags on their cars. In order that subsequent appointments not be forgotten, a recall process has been instituted to remind patients at regular intervals of the opportunity to take advantage of such an examination.

A further central point relates to the financing of the health care system. Demographic studies show that the Austrian population is growing ever older, while at the same time the working-age population is shrinking. The high quality of the Austrian health care system makes it one of the world’s best - and this should remain so in the future. With the Health Care Reform Act, appropriate steps have been taken to be as well-prepared as possible for future challenges.

Mental Health Declaration for Europe: Facing the Challenges, Building Solutions

Argyro Kazaki — Fri, 01 Jun 2007 08:16:00 GMT

This Action Plan is endorsed in the Mental Health Declaration for Europe by ministers of health of the Member States in the WHO European Region. They support its implementation in accordance with each country’s needs and resources.

The challenges over the next five to ten years are to develop, implement and evaluate policies and legislation that will deliver mental health activities capable of improving the well-being of the whole population, preventing mental health problems and enhancing the inclusion and
functioning of people experiencing mental health problems. The priorities for the next decade are to:

foster awareness of the importance of mental well-being;
collectively tackle stigma, discrimination and inequality, and empower and support people with mental health problems and their families to be actively engaged in this process;
design and implement comprehensive, integrated and efficient mental health systems that cover promotion, prevention, treatment and rehabilitation, care and recovery;
address the need for a competent workforce, effective in all these areas;
recognize the experience and knowledge of service users and carers1 as an important basis for planning and developing services.

This Action Plan proposes ways and means of developing, implementing and reinforcing comprehensive mental health policies in the countries of the WHO European Region, requiring action in the 12 areas as set out below. Countries will reflect these policies in their own mental
health strategies and plans, to determine what will be delivered over the next five and ten years.