The Netherlands should do more to help workers with mental ill-health, says OECD


01/12/2014 - The Netherlands should increase support for workers suffering from mental health issues and their employers and tackle the continued social stigma and limited knowledge around such illnesses, according to a new OECD report.


Mental Health and Work: The Netherlands says that one in three people on unemployment, social assistance or disability benefits experience psychological problems such as distress, depression or anxiety. The OECD estimates that mental health issues cost the Dutch economy nearly EUR 20 billion per year, equivalent to 3.3% of GDP, in lost productivity, health care and social spending.


At almost 68%, the employment rate of people with mental ill-health is relatively high in the Netherlands. But absence rates of these workers are one-third higher than in other OECD countries, despite strong incentives for Dutch employers to reduce sickness absence costs. Early action at the workplace is needed to avoid that work-related problems translate into reduced mental well-being, lower productivity and potentially labour market exit.


Public support for unemployment and social assistance beneficiaries temporarily too sick to work due to mental ill-health is insufficient. Case management support in collaboration with mental health specialists should be offered by the public employment service (UWV) and the municipalities as soon as possible after job loss. This can prevent a worsening of mental health problems and reduce the risk of long-term inactivity.   ‌‌‌‌‌NL mental health cost graph

Early action is also needed in the education system. Youth with mental health problems leave school earlier and face higher unemployment rates. The Dutch school system provides a good structure for pupils with social-emotional problems, but the lack of resources restricts the attention to pupils with more severe problems. Preventive programmes in schools are needed, as well as better support for youth in the school-to-work transition.


General practitioners and mental health care providers are neither required nor encouraged to focus on work in the treatment process. Similarly, employment support providers like occupational physicians do not co-ordinate their services with the health sector. Other countries are experimenting successfully with integrated health and work services, for instance by incorporating workplace knowledge and support in health care practices. The forthcoming decentralisation of responsibilities for disadvantaged people to the municipalities provides an opportunity to develop integrated interventions at the local level. 


The Netherlands has seen many important policy changes in the past two decades. In addition the OECD recommends that the Netherlands:


  • Strengthen legislation and monitor employer practice to prevent mental ill‑health at work and ensure sufficient support for employees with mental health problems.
  • Improve the activation approach of the UWV to better support their clients with mental ill-health in re-entering the labour market.
  • Provide direction to schools to implement preventive activities and improve the transition from school to work for adolescents with mental health problems.
  • Develop employment-oriented mental health care and experiment with ways to integrate mental health and employment services.


For further information, journalists should contact Veerle Miranda (tel. +331 4524 1873 / or Iris Arends (tel. +316 1443 7814 /, the authors of the new OECD report, or Spencer Wilson from OECD’s Media division (tel. + 331 4524 8118). For a copy of the report, journalists should contact


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