Workplace conditions

Most research in workplace mental health has been based in developed countries and hence has focused on the employment conditions defined as fair employment, which refers to employment in which there are clear agreements regarding employer-employee relationships. However there are a variety of employment conditions with more unstable workplace environments, as described in the WHO Employment Conditions Knowledge Network (EMCONET) Report by Benach et al (2008). These include precarious employment, defined as temporary work contracts that offer reduced social security and stability; informal employment, which refers to non-regulated arrangements between employers and employees and represents the most prevalent working condition in developing countries; child labour, particularly the employment of children under the age of 12; and slavery, defined as employment in which individuals are forced to work as a result of being subjected to mental or physical abuse with no relationship with their employer other than as a "commodity".

Specific studies investigating the association between workplace environment and CMDs have been biased towards developed countries and workplaces characterised by fair employment working conditions. It can be expected that the prevalence of psychiatric morbidity will be substantially higher amongst individuals in more stressful working conditions. Furthermore the plight of the unemployed varies significantly between countries and is heavily influenced by the availability of a welfare system, in the absence of which the burden may be borne by working family members, thus adding to the already significant burden.

There are various environmental factors that clearly have an influence on the health of workers. At a broad systemic level these include the political environment, policies that govern the labour market, access to basic services including health services and stability of social and family networks. Fairness of workplace processes includes organisational justice, which refers to the fairness of workplace procedures. Low organisational justice has been linked with an increased risk of CMDs. When considering the individual worker, there are hence a myriad of factors that interact and may influence the impact of workplace stress. It may be artificial to separate workplace stress from general environmental stress in many developing countries. The economic status of the nation, living conditions, access to adequate housing and access to recreational pursuits, may all have an indirect impact on the workplace environment. Poverty may also increase the likelihood of other illnesses, which further increase the vulnerability of workers in developing countries.