To examine the association between mental disorders and work disability in the adult resident population in Singapore.
Data are from the Singapore Mental Health Study, which was a household survey of a nationally representative sample. The main instrument used was the Composite International Diagnostic Interview (CIDI). Employment-related information was collected using the modified employment module of the CIDI.
A total of 6,429 respondents were included in the analysis, 71 % (n = 4,594) were employed, 24.5 % (n = 1,522) were economically inactive and 4.5 % (n = 313) were unemployed. Among the employed, 2.3 % had a 12-month prevalence of at least one mental disorder, while 5.3 % of the unemployed had at least one mental disorder. The average number of work loss days (absenteeism) per capita among those with a mental disorder was 0.5 per month that is equivalent to an annualized national projection of approximately 0.3 million productivity days. The average work-cutback days (presenteeism) were 0.4 days among this group. Of the mentally ill in the workforce, a high proportion (86.5 %) did not ever seek help for problems related to mental health.
Our findings provide information on the significant consequences of mental disorders on the workforce in terms of lost work productivity, which could pave the way for a more rational allocation of scarce resources.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Cook JA (2006) Employment barriers for persons with psychiatric disabilities: update of a report for the President’s Commission. Psychiatr Serv 57:1391–1405
Lahelma E (1992) Unemployment and mental well-being: elaboration of the relationship. Int J Health Serv 22:261–274
Scheid T (1993) An investigation of work and unemployment among psychiatric clients. Int J Health Serv 23:763–782
Claussen B, Bjorndal A, Hjort P (1993) Health and re-employment in a two year follow up of long term unemployed. J Epidemiol Community Health 47:14–18
Broadhead WE, Blazer DG, George LK, Kit Tse C (1990) Depression, disability days, and days lost from work in a prospective epidemiologic survey. JAMA 264:2524–2528
Stansfeld S, Feeney A, Head J, Canner R, North F, Marmot M (1995) Sickness absence for psychiatric illness: the Whitehall II Study. Soc Sci Med 40:189–197
Mathers CD, Schofield DJ (1998) The health consequences of unemployment: the evidence. Med J Aust 168:178–182
Morrell SL, Taylor RJ, Kerr CB (1998) Unemployment and young people’s health. Med J Aust 168:236–240
Jin RL, Shah CP, Svoboda TJ (1995) The impact of unemployment on health: a review of the evidence. CMAJ 153:525–540
Hammarstrom A, Janlert U (1997) Nervous and depressive symptoms in a longitudinal study of youth unemployment—selection or exposure? J Adolesc 20:293–305
Montgomery SM, Bartley MJ, Cook DG, Wadsworth MEJ (1996) Health and social precursors of unemployment in young men in Great Britain. J Epidemiol Community Health 50:415–422
Conti DJ, Burton WN (1994) The economic impact of depression in a workplace. J Occup Med 36:983–988
Kouzis AC, Eaton WW (1994) Emotional disability days: prevalence and predictors. Am J Public Health 84:1304–1307
Greenberg PE, Stiglin LE, Finkelstein SN, Berndt ER (1993) The economic burden of depression in 1990. J Clin Psychiatry 54:405–418
Lim D, Sanderson K, Andrews G (2000) Lost productivity among full-time workers with mental disorders. J Ment Health Policy Econ 3:139–146
Sanderson K, Andrews G (2006) Common mental disorders in the workforce: recent findings from descriptive and social epidemiology. Can J Psychiatry 51:63–75
Zhang M, Rost K, Fortney J, Smith R (1999) A community study of depression treatment and employment. Psychiatr Serv 50:1209–1213
Kessler R, Frank G (1997) The impact of psychiatric disorders on work loss days. Psychol Med 27:861–873
Dewa C, Lin E (2000) Chronic physical illness, psychiatric disorder and disability in the workplace. Soc Sci Med 51:41–50
Laitinen-Krispijn S, Bijl RV (2000) Mental disorders and employee sickness absence: the NEMESIS study. Soc Psychiatry Psychiatr Epidemiol 35:71–77
Alegria M, Jackson JS, Kessler RC, Takeuchi D (2003) National Comorbidity Survey Replication (NCS-R), 2001–2003. Inter-university Consortium for Political and Social Research, Ann Arbor
Kessler RC, Berglund P, Chiu WT, Demler O, Heeringa S, Hiripi E et al (2004) The US National Comorbidity Survey Replication (NCS-R): design and field procedures. Int J Methods Psychiatr Res 13:69–92
Sprangers MAG, de Regt EB, Andries F, van Agt HM, Bijl RV, de Boer JB et al (2000) Which chronic conditions are associated with better or poorer quality of life? J Clin Epidemiol 53:895–907
Stewart A, Greenfield S, Hays RD, Well SK, Roger WH, Berry SD et al (1989) Functional status and well-being of patients with chronic conditions: results from the medical outcomes study. JAMA 262:907–913
Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K (1995) Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 52:11–19
Wilson RW, Drury TF (1984) Interpreting trends in illness and disability: health statistics and health status. Annu Rev Public Health 15:83–106
Subramaniam M, Vaingankar J, Heng D, Kwok KW, Lim YW, Yap M, Chong SA (2012) The Singapore Mental Health Study: an overview of the methodology. Int J Methods Psychiatr Res. doi:10.1002/mpr.1351
Kessler RC, Ustun TB (2004) The World Mental Health (WMH) Survey Initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 13:93–121
Bartley M, Ferrie J (2001) Glossary: unemployment, job insecurity, and health. J Epidemiol Community Health 55:776–781
Chong SA, Abdin E, Vaingankar JA, Heng D, Sherbourne C, Yap M, Lim YW, Wong HB, Ghosh-Dastidar B, Kwok KW, Subramaniam M (2012) A population-based survey of mental disorders in Singapore. Ann Acad Med Singap 41:49–66
de Graaf R, Tuithof M, van Dorsselaer S, Ten Have M (2012) Comparing the effects on work performance of mental and physical disorders. Soc Psychiatry Psychiatr Epidemiol [Epub ahead of print]
Schulze B, Angermeyer MC (2003) Subjective experiences of stigma. A focus group study of schizophrenic patients, their relatives and mental health professionals. Soc Sci Med 56:299–312
Stuart H (2006) Mental illness and employment discrimination. Curr Opin Psychiatry 19:522–526
See Me Scotland. See me so far: A Review of the First Four Years of the Scottish Anti-Stigma Campaign. Scottish Executive 2006. http://www.docs.csg.ed.ac.uk/EqualityDiversity/see_me_so_far.pdf. Accessed 25 May 2012
Wahl O (1999) Mental health consumers’ experience of stigma. Schizophr Bull 25:467–478
Wahl O (1999) Telling is risky business: mental health consumers confront stigma. Rutgers University Press, New Brunswick
Kessler RC, Greenberg P, Mickelson K, Meneades L, Wang P (2001) The effects of chronic medical conditions on work loss and work cutback. J Occup Environ Med 43:218–225
McKevitt C, Morgan M, Dundas R, Holland WW (1997) Sickness absence and ‘working through’ illness: a comparison of two professional groups. J Public Health Med 19:295–300
Cook JA, Razzano L, Straiton DM, Ross Y (1994) Cultivation and maintenance of relationships with employers of persons with severe mental illness. Psychosoc Rehabil J 17:103–116
Diksa E, Rogers ES (1996) Employer concerns about hiring persons with psychiatric disability: results of the Employer Attitude Questionnaire. Rehabil Couns Bull 40:31–44
Manning C, White PD (1995) Attitudes of employers to the mentally ill. Psychiatr Bull 19:541–543
Coyne JC, Gotlib IH (1983) The role of cognition in depression: a critical appraisal. Psychol Bull 94:472–505
Dooley D, Prause J, Ham-Rowbottom KA (2000) Underemployment and depression: longitudinal relationships. J Health Soc Behav 41:421–436
Friedland DS, Price RH (2003) Underemployment: consequences for the health and well-being of workers. Am J Community Psychol 32:33–45
Fresco DM, Coles ME, Heimberg RG, Liebowitz MR, Hami S, Stein MB et al (2000) The Liebowitz Social Anxiety Scale: a comparison of the psychometric properties of self-report and clinician-administered formats. Psychol Med 31:1025–1035
Campbell J, Schreiber R, Temkin T (1989) The well-being project: mental health clients speak for themselves. California Department of Mental Health, Office of Prevention, Sacramento
Rogers ES, Walsh D, Masotta L, Danley K, Smith K (1991) Massachusetts survey of client preferences for community support services. Final Report, Center for Psychiatric Rehabilitation, Boston University, Boston
Uttaro T, Mechanic D (1994) The NAMI consumer survey analysis of unmet needs. Hosp Community Psychiatry 45:372–374
Van Dongen CJ (1996) Quality of life and self-esteem in working and nonworking persons with mental illness. Community Ment Health J 32:535–548
Drake RE, Becker DR, Bond GR (2003) Recent research on vocational rehabilitation for persons with severe mental illness. Curr Opin Psychiatry 16:451–455
Van Der Doef M, Maes S (1999) The job demand–control (support) model and psychological well-being: a review of 20 years of empirical research. Work Stress 13:87–114
North FM, Syme SL, Feeney A, Shipley M, Marmot M (1996) Psychosocial work environment and sickness absence among British civil servants: the Whitehall II study. Am J Public Health 86:332–340
Jenkins R (1994) Mental illness and work. In: Floyd M, Povall M, Watson G (eds) Mental health at work. Jessica Kingsley, London, pp 77–79
This research was supported by funding from the Singapore Millennium Foundation and the Ministry of Health, Singapore.
About this article
Cite this article
Chong, S.A., Vaingankar, J.A., Abdin, E. et al. Mental disorders: employment and work productivity in Singapore. Soc Psychiatry Psychiatr Epidemiol 48, 117–123 (2013). https://doi.org/10.1007/s00127-012-0526-5
- Mental disorder