Journal of Occupational Rehabilitation

, Volume 21, Issue 4, pp 547–558 | Cite as

Receiving Treatment, Labor Force Activity, and Work Performance Among People with Psychiatric Disorders: Results from a Population Survey

  • Geoffrey Waghorn
  • David Chant


Introduction Standard treatments for psychiatric disorders such as schizophrenia, depression and anxiety disorders are generally expected to benefit individuals, employers, and the wider community through improvements in work-functioning and productivity. Methods We repeated a previous secondary investigation of receiving treatment, labor force activity and self-reported work performance among people with ICD-10 psychiatric disorders, in comparison to people with other types of health conditions. Data were collected by the Australian Bureau of Statistics in 2003 repeating a survey administered in 1998 using representative multistage sampling strategies. The 2003 household probability sample consisted of 36,241 working age individuals. Results Consistent with the previous secondary investigation based on the 1998 survey administration, receiving treatment was consistently associated with non-participation in the labor force, and was negatively associated with work performance. Conclusions At a population level, receiving treatment was negatively associated with labor force activity and work performance. The stability of these results in two independent surveys highlights the need to investigate the longitudinal relationships between evidence-based treatments for psychiatric conditions as applied in real-world settings, and labor force participation and work performance outcomes.


Psychiatric disorders Disability Employment Treatment Work performance 


  1. 1.
    Waghorn G, Chant D. Receiving treatment and labor force activity in a community survey of people with anxiety and affective disorders. J Occup Rehabil. 2007;17:623–40.PubMedCrossRefGoogle Scholar
  2. 2.
    Sanderson K, Andrews G. Common mental disorders in the workforce: recent findings from descriptive and social epidemiology. Can J Psychiatry. 2006;51:63–75.PubMedGoogle Scholar
  3. 3.
    Kessler RC, Akiskal HS, Ames M, et al. Prevalence and effects of mood disorders on work performance in a nationally representative sample of U.S. workers. Am J Psychiatry. 2006;163:1561–8.PubMedCrossRefGoogle Scholar
  4. 4.
    Stewart WF, Ricci JA, Chee E, Hahn SR, Morganstein D. Cost of lost productive work time among US workers with depression. J American Med Assoc. 2003;289:3135–44.CrossRefGoogle Scholar
  5. 5.
    Schoenbaum M, Unutzer J, McCaffery D, Duan N, Sherbourne C, Wells KB. The effects of primary care depression treatment on patients’ clinical status and employment. Health Serv Res. 2002;37:1145–58.PubMedCrossRefGoogle Scholar
  6. 6.
    Lerner D, Adler DA, Chang H, et al. Unemployment, job retention, and productivity loss among employees with depression. Psychiatr Serv. 2004;55:1371–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Dewa C, Lin E. Chronic physical illness, psychiatric disorder and disability in the workplace. Soc Sci Med. 2000;51:41–50.PubMedCrossRefGoogle Scholar
  8. 8.
    Lim D, Sanderson K, Andrews G. Lost productivity among full-time workers with mental disorders. J Mental Health Policy Econ. 2000;3:139–46.CrossRefGoogle Scholar
  9. 9.
    Kessler R, Frank G. The impact of psychiatric disorders on work loss days. Psychol Med. 1997;27:861–73.PubMedCrossRefGoogle Scholar
  10. 10.
    Conti DJ, Burton WN. The economic impact of depression in a workplace. J Occup Environ Med. 1994;36:983–8.Google Scholar
  11. 11.
    Allen P. For the employer productivity is critical. Healthc Papers. 2004;5:95–7.Google Scholar
  12. 12.
    Berndt ER, Finkelstein SN, Greenberg PE, Howland RH, Keith A. Workplace performance effects from chronic depression and its treatment. J Health Econ. 1998;17:511–35.PubMedCrossRefGoogle Scholar
  13. 13.
    Hilton MF, Scuffham PA, Sheridan J, Cleary CM, Whiteford HA. Mental ill-health and the differential effect of employee type on absenteeism and presenteeism. J Occup Environ Med. 2008;50:1228–43.PubMedCrossRefGoogle Scholar
  14. 14.
    Dewa CS, McDaid D, Ettner SL. An international perspective on worker mental health problems: who bears the burden and how are costs addressed? Can J Psychiatry. 2007;52:346–56.PubMedGoogle Scholar
  15. 15.
    Zhang M, Rost K, Fortney J, Smith R. A community study of depression treatment and employment. Psychiatr Serv. 1999;50:1209–13.PubMedGoogle Scholar
  16. 16.
    Mintz J, Mintz LI, Arruda MJ, Hwang SS. Treatments of depression and the functional capacity to work. Arch Gen Psychiatry. 1992;49:761–8.PubMedGoogle Scholar
  17. 17.
    Druss BG, Schlesinger M, Allen HM Jr. Depressive symptoms, satisfaction with health care, and 2-year work outcomes in an employed population. Am J Psychiatry. 2001;158:731–4.PubMedCrossRefGoogle Scholar
  18. 18.
    Rost K, Smith JL, Dickinson M. The effect of improving primary care depression management on employee absenteeism and productivity: a randomized trial. Med Care. 2004;42:1202–10.PubMedCrossRefGoogle Scholar
  19. 19.
    Verbeek JH. How can doctors help their patients to return to work? PloS Medicine. 2006;3:312–5.CrossRefGoogle Scholar
  20. 20.
    Andrews G. Efficacy, effectiveness and efficiency in mental health service delivery. Aust N Z J Psychiatry. 1999;33:316–22.PubMedCrossRefGoogle Scholar
  21. 21.
    Andrews G, Sanderson K, Corry J, Issakidis C, Lapsley H. Cost-effectiveness of current and optimal treatment for schizophrenia. Brit J Psychiatry. 2003;183:427–35.CrossRefGoogle Scholar
  22. 22.
    Australian Bureau of Statistics. Survey of disability, ageing and carers, Australia. Technical paper. Confidentialised unit record file 1998. Canberra: Commonwealth Government; 1999.Google Scholar
  23. 23.
    Australian Bureau of Statistics. Survey of disability, ageing and carers, Australia. Technical paper revised. Confidentialised unit record file 2003. Canberra: Australian Government; 2005.Google Scholar
  24. 24.
    Waghorn G, Chant D, Harris M. Stability of correlates of labor force activity among people with psychiatric disorders. Acta Psychiatr Scand. 2009;119:393–405.PubMedCrossRefGoogle Scholar
  25. 25.
    Waghorn G, Chant D, Lloyd C, Harris M. Labour market conditions, labour force activity, and prevalence of psychiatric disorders. Soc Psychiatry Psychiatr Epidemiol. 2009;44:171–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Australian Bureau of Statistics. Personal communication. Mr. Peter Walkear, Health and disability section, 19 Dec 2007.Google Scholar
  27. 27.
    National Centre for Classification in Health. ICD-10-AM mental health manual. An integrated classification tool for community-based mental health services. Canberra: Australian Government Department of Health and Ageing; 2002.Google Scholar
  28. 28.
    World Health Organization. International classification of diseases. 10th ed. (ICD-10). Geneva: World Health Organization; 1993.Google Scholar
  29. 29.
    World Health Organization. International classification of impairments, disabilities and handicaps. Geneva: World Health Organization; 1980.Google Scholar
  30. 30.
    Australian Bureau of Statistics. Standards for social, labour and demographic variables. Labour force variables. Canberra: Australian Government; 1999.Google Scholar
  31. 31.
    Australian Bureau of Statistics. Australian Bureau of Statistics classification of qualifications (ABSCQ). Cat. 2901.0. Canberra: Australian Government; 1996.Google Scholar
  32. 32.
    Salyers M, Bosworth HB, Swanson JW, Lamb-Pagone J, Osher FC. Reliability and validity of the SF-12 health survey among people with severe mental illness. Med Care. 2000;38:1141–50.PubMedCrossRefGoogle Scholar
  33. 33.
    Ware JE, Kosinski MA, Keller S. A 12-item short form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–33.PubMedCrossRefGoogle Scholar
  34. 34.
    Slade T, Johnston A, Teeson M, et al. The mental health of Australians 2. Report on the 2007 National Survey of Mental Health and Wellbeing. Canberra: Department of Health and Ageing; 2007.Google Scholar
  35. 35.
    Kish L, Frankel MR. Balanced repeated replications for standard errors. J Am Stat Assoc. 1970;65:1071–94.CrossRefGoogle Scholar
  36. 36.
    Hilton MF, Scuffham PA, Sheridan J, Cleary CM, Vecchio N, Whiteford HA. The association between mental disorders and productivity in treated and untreated employees. J Occup Environ Med. 2009;51:996–1003.PubMedCrossRefGoogle Scholar
  37. 37.
    Lerner D, Adler DA, Rogers WH, et al. Work performance of employees with depression: the impact of work stressors. Am J Health Promot. 2010;24(3):205–13.PubMedCrossRefGoogle Scholar
  38. 38.
    Adler DA, McLaughlin TJ, Rogers WH, Hong C, Lapitsky L, Lerner D. Job performance deficits due to depression. Am J Psychiatry. 2006;163:1569–76.PubMedCrossRefGoogle Scholar
  39. 39.
    Patten SB, Wang JL, Williams JV, Lavorato DH, Bulloch A, Eliasziw M. Prospective evaluation of the effect of major depression on working status in a population sample. Can J Psychiatry. 2009;54(12):841–5.PubMedGoogle Scholar
  40. 40.
    Erickson SR, Guthrie S, Vanetten-Lee M, et al. Severity of anxiety and work related outcomes of patients with anxiety disorders. Depress Anxiety. 2009;26(12):1165–71.PubMedCrossRefGoogle Scholar
  41. 41.
    Sederer LI. Science to practice: making what we know what we actually do. Schizophr Bull. 2009;35(4):714–8.PubMedCrossRefGoogle Scholar
  42. 42.
    Turpin RS, Ozminkowski RJ, Sharda CE, et al. Reliability and validity of the Stanford Presenteeism Scale. J Occup Environ Med. 2004;46:1123–33.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Queensland Health, The Queensland Centre for Mental Health ResearchThe Park Centre for Mental HealthRichlands, via BrisbaneAustralia
  2. 2.The School of Population HealthThe University of QueenslandBrisbaneAustralia
  3. 3.LauncestonAustralia

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