Praxis, the think-tank, thinks work capacity reform should also touch the «ordinary workers» at risk of or sliding towards deteriorated health.

As revealed by a fresh Praxis analysis, work incapacity pensioners include a whopping 32,000 – a third of total – individuals with mental health issues.

«These are people that cannot be helped with a technical aid or a slope for the wheelchair,» said Praxis analyst Vootele Veldre. «Rather, these people would be assisted by flexible wok life, stress management at workplace, responsibility that regards the health condition, and optimal load,» he said listing some suggestions to those preparing the work capacity reform.

In reality, mental health is even more prevalent. According to Health Insurance Fund data, over 87,000 sought medical help last year. During that period, more than 50,000 bought medicines against psychic or behavioural disorders.

The analysts say the reform should concern a broader spectre of people. «As we see it, we will also have to consider those who are healthy as yet, but in danger of health declining leading to possible job loss,» explained Mr Veldre.

The working environment link

Occupational health doctors play an important role detecting mental disorders, suggests Praxis as it criticises the current condition of the service – the doctors do ask employees about stress, but are mainly focussed on physical health.

«The questions regarding stress or mood at work sound secondary and may not necessarily lead to a person opening up,» said Mr Veldre.

Toomas Põld, occupational health doctor at Qvalitas, says they are moving towards considering effects of working environment as cause for things to go amiss in people’s lives. Should employees in a company confess shared problems, they are «able to also connect this to the working environment.»

«Among ten, with two we tend to detect something that needs additional medical check-up, and with one the assumption proves right,» said Mr Põld.

Not allowed to reveal health data of employees to employer, the occupational health doctors may still make proposals regarding change in working environment.

Often, said the doctor, people are reluctant to share their problems for fear of losing the job.

«With good trained employees, who the boss is unwilling to let go, they will be ready to change the working conditions and maybe keep the post open till the person gets treated and stays on longer-term sick leave,» said Mr Põld, encouraging employees to speak their heart.

According to Praxis analyst Märt Masso, mental issues tend to be hidden. «People may be skilled and efficient yet behave somewhat different at times. Knowing the cause, with needed support the more serious problems might be prevented,» he added.

Lower employment and education

A middle aged lady with post-stroke problems related how she was declined a job, the perspective employer underlining they need normal people.

«We are very sensitive anyway, I believe all those handicapped are, as our psychics are a bit otherwise as with healthy people,» said the lady, pointing to a problem to be faced by officials at Töötukassa (Estonian Unemployment Insurance Fund) soon tasked with helping people with mental problems.

Contrary to public image, the work capacity reform – supposed to start in mid-2016 – would be dealing with mental health problems as a central issue.

«We have always been aware that mental health issues are among the largest groups, hence the great need for proper methodology of assessing work capacity,» said social protection minister Margus Tsahkna (IRL).

Mr Veldre from Praxis said both Estonian and international experience says people with mental problems are related to lower employment and education. «Of the 32,000 work incapacity pensioners with persistent mental disorders, less than a third were working and only a half of these earn at least minimal wages,» he said. «For the rest, it’s mainly occasional work and their pay may only amount to a couple of dozen euros or even less.»

Source: The mental health trouble, Postimees