Due to the increase in mental health problems among Japanese workers in recent years, effective approaches to address these problems are of growing concern. Although such an effort is now under way in largescale enterprises (LSEs), small-scale enterprises (SSEs) are lagging behind LSEs for a number of reasons. In the present study, to know the reason, the presidents of 263 SSEs (fewer than 50 employees) in the Ohta ward of Tokyo were surveyed with a self-administered questionnaire from October 1999 to March 2000 (response rate, 51.0%). The main business types were manufacturing (71.2%), transportation & storage (6.1%), and construction (5.3%). The results revealed that employers attribute the mental health problems of employees to "Job content/Aptitude for job (78.6%)", "Communication among employees (71.0%)", "Physical problems/Illness (50.4%)", "Family problems (33.6%)". These results are very similar to those obtained in the same enterprises employees survey in 1996, suggesting that employers perceive the factors responsible for employees' mental health problems with substantial accuracy. Sixty-nine point five percent of the employers answered that they need mental health measures for employees. And 62.7% of employers agreed to take mental health measures in their enterprises. Taken together, it is considered that employers are willing to improve their employees' mental health problems. Nevertheless, 95% of employers are doing nothing to improve the situation. The major reasons cited were 1) Cannot obtain a consultant or counselor (44.8%), 2) Lack of time (43.1%), 3) Manpower shortage (41.4%), 4) Difficulty in ensuring employees' privacy (36.2%), and 5) Lack of financial resources (30.2%). The results of the present study suggest that perception of the mental health problems among employers and employees of SSEs in the Ohta area were close to each other. Effective strategies are needed to improve mental health problems in SSEs.
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