An international perspective on worker mental health problems: Who bears the burden and how are costs addressed?

Carolyn S Dewa, David McDaid, Susan L. Ettner

Research output: Contribution to journalReview articlepeer-review

60 Scopus citations


Objective: To discuss the burden of poor mental health in workers, who currently bears it, and how the associated rising costs are being addressed, from an international perspective. Method: We identify the stakeholder groups and the costs they incur as a result of problems related to mental health in 6 different domains. In addition, we offer examples of programs, services, and strategies being used to either decrease costs or enhance benefits. Results: Mental illness is associated with a wide range of costs distributed across multiple stakeholders including government, employers, workers and their families, and the health care system. The costs incurred by the groups are interrelated; an attempt to decrease the burden for one group of stakeholders will inevitably affect other stakeholders. Thus the answer to the question of who bears the costs of poor mental health is "everyone." Conclusions: Everyone could benefit from investment in improved mental health in the workplace. However, because the benefits associated with improved worker mental health are often distributed among several stakeholders, the incentives for any single stakeholder to pay for additional services for workers may be diluted. As a consequence, no one invests. Nevertheless, there is a role for all stakeholders, just as there are potential benefits for all. Along with government, employers, employees, and the health care system must invest in promoting good workplace health.

Original languageEnglish (US)
Pages (from-to)346-356
Number of pages11
JournalCanadian Journal of Psychiatry
Issue number6
StatePublished - Jun 2007
Externally publishedYes


  • Absenteeism
  • Disability
  • Insurance
  • Mental health
  • Public policy
  • Social welfare
  • Workplace

ASJC Scopus subject areas

  • Psychiatry and Mental health


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