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Switzerland needs to do more to help people with mental disorders find a job or stay in work, according to a new OECD report.

Mental Health and Work: Switzerland says that about one in three people on unemployment, disability or social assistance benefit has a mental disorder. The unemployment rate of people with mental illness is more than double the overall rate.

A more effective approach would help workers and firms alike: mental health issues are estimated to cost the Swiss economy around SFR 19 billion, equivalent to 3.2% of GDP per year, in lost productivity, health care and social spending.

Employers should be given more responsibility to deal with mental health problems in the workplace and work together with sickness insurers: comprehensive employee follow-up and return-to-work planning can lower absence days (sickness management). Employers should also be required to contact the disability insurance quickly when health issues arise for one of their employees.

Employment services also need to play an active role says the report: they need to identify and address mental health problems of jobseekers early on in close cooperation with the health sector. Special strategies are needed to deal with the sick unemployed and those exhausting their unemployment benefit entitlement – two groups with a high prevalence of mental ill-health.=

Disability benefit reforms in the past decade successfully reduced the number of new benefit claims. The disability benefit caseload, however, remains high and reforms aimed at bringing current claimants back into the labour market, especially those with a mental disorder, have yet to deliver better outcomes.

According to the OECD report health services are very accessible in Switzerland and the number of treating psychiatrists is much larger than in any other OECD country. Treating people with the aim of helping them get back to work, however, is not widespread and there is no link between health and employment services, or between workplaces and doctors. Other countries are experimenting successfully in this field.

Change is also needed in other areas says the report, notably the education system. Youth with mental disorders who drop out from upper-secondary education or vocational school do not receive any support. Job prospects for the low-skilled have fallen drastically in the past decade, and disability benefit claims of youth with a mental illness keep rising despite successful disability reforms.

The OECD recommends that the Swiss authorities:

  • Strengthen the prevention of sickness absences at the workplace and reduce the impact of absences through intensified return-to-work efforts.
  • Enhance the capacity of employment services and social welfare offices to deal with the frequent mental health problems of their clients.
  • Move the disability benefit system closer to the work sphere with a focus on the role of employers and workplace-oriented early interventions.
  • Assure that the mental health system is better placed to deliver good employment outcomes also by promoting a better allocation of resources toward adequate doctor training.
  • Place a greater emphasis of the education policy on ensuring that students with mental health problems do not leave the education system early.