Mental Health and Work: Switzerland This Work Is Published on the Responsibility of the Secretary-General of the OECD
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Mental Health and Work SwITZERLAND Contents Mental Health and Work Executive summary Assessment and recommendations SWITZERLAND Chapter 1. Mental health and work challenges in Switzerland Chapter 2. Working conditions and sickness management in Switzerland Chapter 3. From payments to interventions: A decade of Swiss disability reforms Chapter 4. Swiss co-operation to tackle long-term unemployment and inactivity Chapter 5. Making more of the potential of the Swiss mental health care system Chapter 6. The capacity of the Swiss education system to manage mental-ill health Further reading Sick on the Job? Myths and Realities about Mental Health and Work (2012) Mental Health and Work: Belgium (2013) Mental Health and Work: Denmark (2013) Mental Health and Work: Sweden (2013) Mental Health and Work: Norway (2013) Mental Health and Work www.oecd.org/els/disability Sw ITZERLAND Consult this publication on line at http://dx.doi.org/10.1787/9789264204973-en. This work is published on the OECD iLibrary, which gathers all OECD books, periodicals and statistical databases. Visit www.oecd-ilibrary.org for more information. ISBN 978-92-64-20496-6 81 2013 25 1 P 9HSTCQE*caejgg+ Mental Health and Work: Switzerland This work is published on the responsibility of the Secretary-General of the OECD. The opinions expressed and arguments employed herein do not necessarily reflect the official views of the Organisation or of the governments of its member countries. This document and any map included herein are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Please cite this publication as: OECD (2014), Mental Health and Work: Switzerland, Mental Health and Work, OECD Publishing. http://dx.doi.org/10.1787/9789264204973-en ISBN 978-92-64-20496-6 (print) ISBN 978-92-64-20497-3 (PDF) Series: Mental Health and Work ISSN 2225-7977 (print) ISSN 2225-7985 (online) The statistical data for Israel are supplied by and under the responsibility of the relevant Israeli authorities. The use of such data by the OECD is without prejudice to the status of the Golan Heights, East Jerusalem and Israeli settlements in the West Bank under the terms of international law. Photo credits: Cover © Inmagine ltd. Corrigenda to OECD publications may be found on line at: www.oecd.org/publishing/corrigenda. © OECD 2014 You can copy, download or print OECD content for your own use, and you can include excerpts from OECD publications, databases and multimedia products in your own documents, presentations, blogs, websites and teaching materials, provided that suitable acknowledgment of the source and copyright owner is given. All requests for public or commercial use and translation rights should be submitted to [email protected]. Requests for permission to photocopy portions of this material for public or commercial use shall be addressed directly to the Copyright Clearance Center (CCC) at [email protected] or the Centre français d'exploitation du droit de copie (CFC) at [email protected]. FOREWORD – 3 Foreword 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. A first OECD report on this subject, “Sick on the Job? Myths and Realities about Mental Health and Work”, published in January 2012, identified the main underlying policy challenges facing OECD countries by broadening the evidence base and questioning some myths around the links between mental ill-health and work. This report on Switzerland is one in a series of reports looking at how these policy challenges are being tackled in selected OECD countries, covering issues such as the transition from education to employment, the role of the workplace, the institutions providing employment services for jobseekers, the transition into permanent disability and the capacity of the health system. The other reports look at the situation in Australia, Austria, Belgium, Denmark, the Netherlands, Norway, Sweden and the United Kingdom. Together, these nine reports aim to deepen the evidence on good mental health and work policy. Each report also contains a series of detailed country-specific policy recommendations. Work on this review was a collaborative effort carried out jointly by the Employment Analysis and Policy Division and the Social Policy Division of the OECD Directorate for Employment, Labour and Social Affairs. The report was prepared by Veerle Miranda and Christopher Prinz (project leader) from the OECD and Niklas Baer from the Psychiatric Service of the Canton Basel-Landschaft in Switzerland. Statistical work was provided by Dana Blumin and Maxime Ladaique. Valuable comments were provided by Mark Keese and Stefano Scarpetta. The report also includes comments from a number of Swiss experts, ministries and authorities, including the Federal Social Insurance Office, the State Secretariat of Economic Affairs and the Federal Office of Public Health. MENTAL HEALTH AND WORK: SWITZERLAND © OECD 2014 TABLE OF CONTENTS – 5 Table of contents Acronyms and abbreviations ....................................................................................... 9 List of the Swiss cantons ............................................................................................. 11 Executive summary ..................................................................................................... 13 Assessment and recommendations ............................................................................ 15 Chapter 1. Mental health and work challenges in Switzerland ............................ 23 Definitions and objectives ......................................................................................... 24 Key trends and outcomes .......................................................................................... 28 Description of the Swiss social protection system .................................................... 32 Conclusion ................................................................................................................ 34 Notes ......................................................................................................................... 35 References ................................................................................................................. 35 Chapter 2. Working conditions and sickness management in Switzerland ............. 37 Working conditions and mental ill-health ................................................................. 38 Addressing psychosocial risks at work ..................................................................... 41 Sickness management at the workplace .................................................................... 43 Financial responsibility of the employer ................................................................... 45 Conclusion ................................................................................................................ 50 Notes ......................................................................................................................... 52 References ................................................................................................................. 53 Chapter 3. From payments to interventions: a decade of Swiss disability reforms ........................................................................................................ 55 Mental disorders have been a key factor driving the rise in disability benefit claims ........................................................................................ 56 Who are the “new” claimants? .................................................................................. 58 Addressing the high number of new benefit claims .................................................. 61 Benefit adequacy and work incentives ...................................................................... 75 Addressing the high benefit caseload ........................................................................ 80 Conclusion ................................................................................................................ 89 Notes ......................................................................................................................... 92 References ................................................................................................................. 93 MENTAL HEALTH AND WORK: SWITZERLAND © OECD 2014 6 – TABLE OF CONTENTS Chapter 4. Swiss co-operation efforts to tackle long-term unemployment and inactivity ............................................................................................................... 97 The relevance of different benefit schemes ............................................................... 98 Frequent transitions from one benefit to another .................................................... 100 No identification of unemployed with mental health problems .............................. 103 Better