A mental health care program and sickness absence in a Japanese manufacturing plant.

After the Japanese government initiated the Total Health Promotion Plan in 1988, which included psychological consultations at worksites, the actual number of such consultations carried out was extremely low. In 1997, the Ministry of Labour found that only 26.5 % of companies performed mental health care programs, and that where programs did exist, they consisted of sport/recreation (52.6%), interviews during annual health checkups (50.1%), employee education through leaflets (40.1%), and lectures for management (13.2%) . Therefore, in 2000 the Ministry formulated guidelines for the promotion of workers’ mental health at workplaces focusing on four key categories in key areas: improvement of the work environment, education/training, health care for stress, and mental health services . The guidelines also provided a framework for mental health care to be performed by employees and managers in conjunction with both onsite and off-site occupational health care professionals. Much importance will be attached to the mental health care for workers in Japanese companies. The relationship between the mental health services and absenteeism has been investigated previously in other countries. Several studies found that absenteeism among clients declined after treatment and these reductions were maintained for five years after treatment, in which mental health care programs were alcohol specific programs in which supervisors referred employees with problems for treatment. In Japan, only one study has ever evaluated the relationship between a work-related stress reduction program and sickness absence, but in the study sickness absence data were collected by means of a self-reporting questionnaire and not verified by a medical certification. We studied the trend in sickness absence 2.5 yr before and after the introduction of a mental health care program at a manufacturing plant in the Kanto area.