Stress lavoro correlato

Stress lavoro correlato e benessere organizzativo

Introduction

A key component of the World Health Organisation (WHO) definition of health is the notion of the capacity to participate in community life, rather than the traditional narrower view of health as the absence of disease. According to this definition, health refers to "a state of wellbeing in which the individual...is able to work productively and fruitfully, and is able to make a contribution to his or her community". Mental health encompasses the individual's capacity to cope with internal needs as well as external needs, such as roles within employment. Existing studies have predominantly focused on the complex inter-relationship between mental health and work productivity in developed countries. Yet according to the WHO, about 75% of the world's labour force is based in developing countries. There is a relative lack of research focusing on this relationship within workplace settings in developing countries.

Mental illnesses, and in particular Common Mental Disorders (CMDs) such as depression and anxiety, are among the most frequent causes of occupational disability. The burden of CMDs is under-recognised in developing countries, despite strong evidence regarding its social impact. Depression is expected to be the second most common disorder across the world behind ischaemic heart disease by 2020 and is expected to account for 15% of the total disease burden. Despite this, several population-based studies in developed countries have demonstrated that CMDs are under-recognised and under-treated. According to the Australian National Survey of Mental Health and Wellbeing for example, only 35% of people identified with mental illness sought treatment. Furthermore the 12-month prevalence of anxiety disorders was 9.7% and depressive disorders was 5.8%, yet only 28% and 40% respectively of individuals sought treatment. Similarly, according to the New Zealand Mental Health Survey, 58% of those with serious disorders and only 36.5% of those with moderate disorders sought treatment in the preceding 12 months.

The economic burden of depression alone is substantial. Depression is often chronic and hence may result in enduring disability. Greenberg et al (1996) estimated that in 1990, depression cost the US economy US$53 billion annually, of which US$33 billion was a consequence of reduction in work productivity. A follow-up study by the same author in 2000 indicated that although the rate of treatment of depression increased, its economic burden rose only slightly, allowing for inflation, to US$83 billion, suggesting that the economic burden of depression has been relatively stable. It is poignant that in the intervening period there has been relatively little attention given to the concept of the global impact of CMDs with respect to loss in workplace productivity.

Workplace factors may precipitate illness as well as perpetuate disability associated with mental illness. There is good evidence that certain kinds of workplace stress are associated with a higher risk of psychiatric morbidity. It could be expected that the incidence of such workplace stress is higher in developing countries. Thus far, social attention has focused primarily on the impact of harsh working environments on people's human rights, rather than their emotional wellbeing specifically.

This selected review of the recent literature will focus on the current understanding of the relationship between CMDs and work productivity, and also the manner in which workplace environment may adversely impact on mental health. A case will then be presented calling for further attention specifically in developing countries, including research with the agenda of understanding this relationship in order to facilitate the development of effective interventions in the workplace setting.