Mental health affects future employment as job loss affects mental health: findings from a longitudinal population study

Abstract

BackgroundWorkforce participation is a key feature of public mental health and social inclusion policies across the globe, and often a therapeutic goal in treatment settings. Understanding the reciprocal relationship between participation and mental health has been limited by inadequate research methods. This is the first study to simultaneously examine and contrast the relative effects of unemployment on mental health and mental health on employment status in a single general population sample.MethodData were from working-age respondents (20 to 55 years at baseline) who completed nine waves of the Household, Income and Labour Dynamics in Australia (HILDA) Survey (N=7176). Cross-lagged path analyses were used to test the lagged and concurrent associations between unemployment and mental health over time, adjusting for sociodemographic characteristics.ResultsMental health was shown to be both a consequence of and risk factor for unemployment. Thus, the poorer mental health observed amongst people who are not working is attributable to both the impact of unemployment and existing mental health problems. While the strength of these two effects was similar for women, the results for men suggested that the effect of unemployment on subsequent mental health was weaker than the effect of mental health on subsequent risk of unemployment.ConclusionDisentangling the reciprocal links between mental health and workforce participation is central to the development and success of clinical goals and health and social policies that aim to promote either aspect. This study demonstrates that both effects are important and supports concurrent responses to prevent a cycle of disadvantage and entrenched social exclusion.

Mental disorders and employment status in the São Paulo Metropolitan Area, Brazil: gender differences and use of health services

“…This involves not only individual financial losses, but also individual suffering and family emotional and financial burden, as well as societal load, since absenteeism and presenteeism heavily impact employers and social welfare systems 6,8,9,11,16,21,29,30,31,32 . Regarding use of health services, the early detection and adequate treatment are important steps to reduce the impact and burden of mental disorders in general, and specifically related to employment status, they may be strong determinants of returning to the workforce 29,30 . In our study, treatment seeking among those suffering from 12m-MD was more frequent among the economically inactive, both in general and mental health services, adjusting for sociodemographic characteristcs and psychiatric comorbidities.…”

The Bilateral Relationship between Depressive Symptoms and Employment Status

“…The policy implications of mental health problems differ if they are consequences rather than determinants of adverse labor market events (see Olesen et al 2013). …”

“…He finds a negative impact of unemployment on mental health in Britain, with larger effects for men than women. 7 In particular, Dooley et al (1994) find no support for an effect of depression on subsequent unemployment, while Jefferis et al (2011) and Olesen et al (2013) find evidence of a reciprocal relationship that is substantially stronger from unemployment to depression rather than the reverse. Andreeva et al (2015) find that depressive symptoms are associated with a higher likelihood of being unemployed in the future for women, but not men.…”

“…In more recent work, Olesen et al (2013) estimate the reciprocal correlations between unemployment and depressive symptoms using population level data from Australia. Related research also sheds light on the relationship between depression and other employment experiences.…”

“…6 Unfortunately, this extensive literature tells us very little about the nature of the bilateral relationship between mental health and labor market outcomes. Empirical evidence from epidemiological studies indicates that unemployment is often associated with a heightened risk of depressive mood disorders subsequently; there is less empirical support for an association between depression and future unemployment (Dooley et al 1994;Jefferis et al 2011;Olesen et al 2013;Andreeva et al 2015). 7 Most economic studies, however, begin with a maintained assumption about the direction of causality -i.e.…”