Published from Florence Fee in the Financial Times – January 25, 2012

“Sir, Michael Skapinker (“Employers need help with the mentally ill”, January 19) needs to understand that while most employers would probably not take on someone with major medical illness since functionality might be impaired, they do prioritize good mental health for their workers, because, of the top 10 disorders in terms of cost for both claims and productivity, depression and anxiety rank number 1 and number 5.

As the government’s chief public health agency, the Centers for Disease Control, has said: “Mental health is recognized by the public health community as critical to good health.”

Experts have described four categories of people:

1. The well who are also not ill (the gold standard – what we all aspire to be).
2. The ill who are well, characterized by people who, despite illness, can cope and maintain a positive outlook.
3. Those neither well nor ill, (not ill per se, but who also do not have a positive orientation towards health and lack healthy behaviors).
4. The ill who are not well (most individuals with chronic illness, whose lives deteriorate and who withdraw from active social involvement).

The vast majority of Americans sadly fall into group 3: neither ill nor well. Employers in their internal health promotion programs are trying to move employees from group 3 into group 1.

So, in both business and society, we have to look at addressing the prevention and treatment of mental illness and at the promotion of mental health. As this happens, our organization believes the social stigma now still surrounding mental illness will gradually wane.

Florence Fee, President, No Health Without Mental Health NHMH Inc, Arlington, VA, US

Integrated care increases general medical doctors’ satisfaction, and depression treatment skills

(Levine et al, GHP 27: 383-391, 2005)