Mental health problems, both clinical (e.g., major depression, anxiety disorders) and subclinical (e.g., psychological distress), are common in the working population. In a review of its approximately 35 member states, the OECD estimated that similar proportions of working-age populations are affected by clinical mental disorders: Point prevalence estimates are 5% for severe mental disorders and another 15% for moderate mental disorders (OECD, 2012). Among those affected, persons with common mental disorders-depression, simple phobia, and generalized anxiety disorder-have the highest workforce participation rates (Sanderson & Andrews, 2006). In Australia, for example, the 2007 national survey of mental health and well-being estimated that 15% of the working population had a history of major depressive disorder (Cocker, Sanderson, & LaMontagne, 2017). Subclinical mental health problems and generalized distress also are prevalent in the working population.Mental health problems among working people are costly to society at large and to health care systems, employers, and affected individuals and their families. Estimates of economic costs for European Union countries are 3% to 4% of gross domestic product (International Labour Office, 2000; OECD, 2012). An Australian study found the greatest costs of depression among working people were borne by employers; turnover costs figured most prominently (Cocker et al., 2017). Costing studies to date, however, have been limited in their ability to quantify costs to affected individuals and their families, particularly concerning important social costs related to stigma and discrimination.
WORKING CONDITIONS AS MODIFIABLE RISK AND PROTECTIVE FACTORSA substantial body of research has demonstrated the links between psychosocial working conditions-or job stressors-and worker health over the past 3 decades. The demand-control model has been particularly influential. It hypothesizes that high job strain, defined by a combination of low control over how the job is done in the face of high job demands, will be harmful to health. Although first demonstrated in relation to cardiovascular disease outcomes, subsequent studies have found that job strain also predicts elevated risks of common mental disorders (Theorell et al., 2015). Numerous other job stressors, either individually or in combination, have also been shown to influence mental health (LaMontagne, Keegel, Louie, & Ostry, 2010). These stressors include job insecurity, bullying and harassment, low social support at work, organizational injustice, and effort-reward imbalance.Unlike many historically prominent occupational exposures (e.g., asbestos) to which only a small proportion of the working population were exposed, all