Occupational Medicine Advance Access originally published online on June 19, 2006
Occupational Medicine 2006 56(6):414-421; doi:10.1093/occmed/kql041
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Reported incidence and precipitating factors of work-related stress and mental ill-health in the United Kingdom (1996–2001)
1 Department of Public Health Sciences, University of Alberta 13-103 Clinical Sciences Building, Edmonton, Alberta, Canada T6G 2G3
2 Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
3 Occupational and Environmental Medicine, Imperial College School of Medicine, London, UK
Background Work-related mental ill-health appears to be increasing. Population-based data on incidence are scarce but in the United Kingdom occupational physicians and psychiatrists report these conditions to voluntary surveillance schemes.
Aims To estimate the incidence of work-related stress and mental illness reported 1996–2001 by occupational physicians and 1999–2001 by psychiatrists.
Methods Estimated annual average incidence rates were calculated by sex, occupation and industry against appropriate populations at risk. An in-house coding scheme was used to classify and analyse data on precipitating events.
Results An estimated annual average of 3624 new cases were reported by psychiatrists, and 2718 by occupational physicians; the rates were higher for men in reports based on the former and for women on the latter. Most diagnoses were of anxiety/depression or work-related stress, with post-traumatic stress accounting for 
10% of cases reported by psychiatrists. High rates of ill-health were seen among professional and associated workers and in those in personal and protective services. Factors (such as work overload) intrinsic to the job and issues with interpersonal relations were the most common causes overall.
Conclusions The steep increase in new cases of work-related mental ill-health reported by occupational physicians since 1996 may reflect a greater willingness by workers to seek help but may also signify an increasing dissonance between workers' expectations and the work environment. Greater expertise is needed to improve the workplace by adjustment of job demands, improvement of working relations, increasing workers' capacities and management of organizational change.
Keywords Mental ill-health; stress; surveillance; work-related
Correspondence to: Nicola M. Cherry, Department of Public Health Sciences, University of Alberta, 13-103 Clinical Sciences Building, Edmonton, Alberta, Canada T6G 2G3; e-mail: Nicola.Cherry{at}ualberta.ca