Introduction

Recent years have seen significant policy attention focused on mental health and employment. The latter part of 2009 saw the publication of several key documents, including the first national strategy on mental health and employment (Health, Work and Wellbeing Directorate, 2009), an overarching framework for mental health service provision (HM Government, 2009a), a review of support for people not in employment due to mental health conditions (DWP, 2009), a strategy on employment support for people in contact with secondary mental health services (HM Government, 2009b) and public health guidelines for line managers on creating mentally healthy workplaces (NICE, 2009). Preceding these reports, Dame Carol Black's 2008 review of the health of the working-age population drew particular attention to the prevalence of mental ill health and its substantial impact on absenteeism and worklessness (Black, 2008; Lelliott et al, 2008).

This suite of publications covers a diverse range of economic and social concerns, from supporting the employment of people who experience severe mental health conditions, through reducing the incapacity benefits bill (the largest proportion of which is attributable to mental ill health), to the promotion of positive mental wellbeing among the whole workforce. In a chapter of this size it is only possible to focus on a few of these areas. The present discussion will concentrate on the retention of paid employment, rather than transitions into work from unemployment and the main focus will be on what are known as mild to moderate or common mental health problems. These terms are generally used to denote a range of anxiety conditions and less severe forms of depression that ‘cause marked emotional distress and interfere with daily function, but do not usually affect insight or cognition’ (Deverill and King, 2009, p 25). While not currently a diagnostic category in itself, work-related stress is often discussed in the same context. For example, Waddell and Burton (2006, p 22) state that stress ‘may be the best modern exemplar of common mental health problems’, while a report for the mental health charity Mind (Robertson, 2005, p 7) considers that ‘stress at work is now one of the most common forms of mental distress’.