05/17/2004

Work-related mental disorders

At a time when stress at work is becoming a subject of growing concern, a
European working group has studied the question of the recognition of illnesses
of psychosocial origin as occupational diseases in thirteen countries. Eurogip,
which coordinated the work, publishes a study report.

Nowadays, it is commonly agreed that the working environment can have an impact
on the mental health of workers. Accordingly, the competent organisations and
enterprises are taking action to prevent psychosocial risks such as stress,
harassment, violence, mobbing, etc. The thirteen countries covered by the
survey recognise as an "occupational injury" the mental or psychological
sequels of an accidental event such as a hold-up. But from there to recognising
as occupational diseases, and hence paying compensation for them as such,
mental disorders or illnesses (depressions, neuroses, obsessive-compulsive
disorders, etc.) related to psychosocial risks, there is a long way to
go.

Recognition on a case by case basis in six countries

At present, such recognition is possible in six countries: Belgium, Denmark,
France, Italy, Portugal and Sweden. Sweden was the precursor, in 1980, followed
by Denmark in 1990, but such recognition has become possible only very recently
in the other countries.

In these six countries, however, recognition takes place within the framework
of the "complementary" or "mixed" system. In other words, illnesses of
psychosocial origin do not appear on the lists of occupational diseases for
these countries. It is therefore up to the victim to provide proof that his
(her) illness is work-related.

Now, a feature of these illnesses is their often multifactorial origin. While
it is relatively easy to demonstrate the origin of an illness related to
exposure to harmful products, it is far more complicated to prove that a
difficult working environment is the "decisive" or "essential" cause of a
depression or a heart complaint, for example.

Especially since there are no clearly established definitions of work-related
mental illnesses. Accordingly, each country sets its criteria: "exceptional
severity" and "permanent sequels" in Denmark; exclusion of illnesses related to
interpersonal relations in Italy and Sweden, etc.

In seven countries, recognition is currently impossible

Germany, Austria, Finland, Luxembourg, Switzerland, Spain and Ireland for the
time being offer no possibility of recognition of mental illnesses as
occupational diseases.

In the latter two countries, the reason for this is simple: only those
illnesses registered on the list of occupational diseases are recognised as
such. In Germany, based on the research carried out until now, "psychosocial"
diseases do not comply with the definition of an occupational disease,
according to which some groups of people are, due to their professional
activity, more exposed than others to specific risks. In Finland, a working
group set up by the Ministry of Social Affairs and Health to examine the
question, involving social partners, doctors, scientists, etc., unanimously
considered that mental disorders should not appear on the list of occupational
diseases, unless the existence of a causal link between a mental risk at work
and a mental disorder could be demonstrated with certainty.


For its part, the European Commission too, at the end of 2003, did not consider
it advisable to mark on the European list of occupational diseases the mental
health complaints caused by psychosocial factors.

Recent and current research

Although few cases may be recognised, this does not necessarily mean that there
are no claims for recognition of "psychosocial" diseases. Such diseases even
rank among the diseases for which the greatest number of claims are made in
Denmark, Sweden and the Netherlands. Germany, where recognition is nevertheless
impossible, also receives some claims.

The increasing number of claims for recognition, the growth in the number of
cases recognised and increasingly strong social demand help explain why
research is being carried out.

In those countries in which recognition is currently impossible, research tends
to confirm this position. In the other countries, the research is designed to
better define the framework for recognition of and compensation for
psychosocial diseases.

In Italy, for example, instructions are to be circulated to the central and
regional offices of INAIL regarding how to assess the risks involved and the
worker's prior psychological condition, and regarding establishment of the
diagnostic and any tests and visits to be provided for so as to reach a
clinical and then forensic diagnostic. In France, a study funded by the
occupational risks department of the National Health Insurance Fund for
Employees (CNAMTS) concerning moral harassment, the results of which are due to
be presented at the end of 2004, should make it possible to define an interview
and diagnosis protocol for use by the industrial doctor.

Further Information


AplusA-online.de - Source: European Agency for Safety and Health at Work