It is a surprising in some ways that the interaction between employment and mental health or illness has not been subject to greater scrutiny, considering the amount of time the average person spends at work in his lifetime and the risks to mental health that the working environment provides. Probably the stigma of mental illness from the point of view of the employee, and the financial concerns about liability from the point of view of the employer, link together to hinder the exploration of the topic. Nevertheless, contemporary views of health promotion (WHO, 1986) and the Social Determinants of Health (CSDH, 2011) recognise the impact of employment on health and mental health and various strategies like Health Promoting Workplaces suggest ways of ameliorating the risks and improving employee health overall. It is however necessary to consider a wide definition of employee health to encompass (a) the health of individuals who perform work for a living, (b) the average forty year period of the life span in which employees are in the work environment, (c) the traditional concerns of work related injury but is not restricted to this, and (d) the health promotion aims of quality of life or state of optimum health and striving to reach one's potential. This chapter explores employment and mental illness with this definition of employee health in mind. The main discussion areas are: employment and its link to the burden of mental illness, risks within contemporary employment, and social relationships in the workplace. The key points that will be made are that employment must be considered in the genesis and treatment strategies of mental illness, and that dialogue about mental illness will need to play a greater part in the employer-employee master narrative.