Tackling mental ill-health of the working-age population is becoming a key issue for labour market and social policies in many OECD countries. It is an issue that has been neglected for too long despite creating very high and increasing costs to people and society at large. OECD governments increasingly recognise that policy has a major role to play in improving the employment opportunities for people with mental ill-health, including very young people especially; in helping those employed but struggling in their jobs; and in avoiding long-term sickness and disability caused by a mental disorder.

Throughout the OECD, mental ill-health is increasingly recognised as a major issue for social and labour market policy since it creates significant costs for people, employers and the economy at large by harming well-being, lowering employment, raising unemployment and generating substantial productivity losses. The Swiss approach to dealing with this problem presents a mixed picture.

Mental ill-health represents a high cost for the Swiss economy, accounting for roughly 3.2% of GDP through lost productivity of workers and increased health care costs and social spending for those temporarily or permanently out of work. While the Swiss labour market is in good shape, and the impact of the recent economic downturn was comparatively small, people with mental ill-health underperform in the job market: their unemployment rate is almost three times the average level and their employment rates are lower.

Building on the findings in the recently published OECD report “Sick on the Job?” this chapter highlights the key challenges facing Switzerland in the area of mental health and work. It provides an overview of the current labour market performance of people with a mental disorder in Switzerland compared to other OECD countries, as well as their financial situation. The chapter also describes the Swiss social protection system which provides the context in which mental health and work policies operate.

Employers are ideally placed to help people in the workforce to deal with mental health problems and retain their jobs. This chapter first describes the link between mental ill-health and working conditions, reduced productivity and sick leave. It then discusses prevention strategies to address psychosocial risks at work as well as sickness management strategies of Swiss companies. The chapter ends with a review of the financial responsibility of Swiss employers in the case of sickness absence.

In the past decade, the Swiss disability benefit system has undergone a series of far-reaching reforms with a strong focus on mental health in order to tackle a steep and steady rise of beneficiaries with mental disorders. This chapter gives an overview of the nature of these reforms, such as the introduction of medical services within the disability insurance which can overrule the assessments of treating physicians and the new focus on early intervention and vocational reintegration of disability beneficiaries, and a preliminary assessment of their impact to date. Beyond the reforms, changes in the legislation and an intense public debate seem to have supported the awareness of all actors leading to a significant decline in new claimants into disability benefits. However, important challenges remain.

This chapter looks at the ability of the unemployment benefit scheme and the social welfare system in Switzerland to deal with the high prevalence of mental illness among their clients. It discusses awareness of the issue as well as means to identify mental health problems and help people with such problems to re-enter the labour market. The chapter’s main focus is on the current status, role, impact and future potential of inter-institutional co-operation which was introduced more than a decade ago and has been under constant development since.

This chapter assesses the performance of the mental health care system in Switzerland in providing adequate treatment to persons with mental disorders. While very comprehensive, there is potential to reach even more of those needing treatment. Therefore, the chapter looks at the role and collaboration of different mental health care providers and the potential for further improvements. The contributions of psychiatric services and physicians in private practice to facilitate job retention and re-integration are assessed, and barriers as well as possibilities to engage more actively in health-related work problems are discussed.

This chapter assesses the capacity of the Swiss education system to provide support to vulnerable children and youth with a mental disorder during their school careers and transitions into the labour market. It first examines the effectiveness of the support measures and services available for students with a mental disorder and their teachers and parents. The chapter then discusses the school-to-work transition and addresses the problem of early labour market exit. It concludes by reviewing policies directed at the early identification of problems of mental ill health among school leavers and young adults.