The importance of employment and its links with mental health are summarised and the European policy context described. The report then asks what the consequences of poor mental health for economic activity are, if a trend in productivity losses over time can be seen and what we know about employment rates for people with mental health problems. Barriers to employment, the economic case for helping such people remain in the workforce, assessing the cost effectiveness of interventions to this end, legislative and policy actions, and the way forward are discussed.