Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 6, pp 1013–1021 | Cite as

Poor mental health influences risk and duration of unemployment: a prospective study

  • Peter Butterworth
  • Liana S. Leach
  • Jane Pirkis
  • Margaret Kelaher
Original Paper

Abstract

Purpose

The current paper aims to investigate the role of mental health in determining future employment status. Much of the previous longitudinal and prospective research has focused on how unemployment adversely influences mental health, while the reverse causal direction has received much less attention.

Methods

This study uses five waves of data from 5,846 respondents in the HILDA survey, a nationally representative household panel survey conducted annually since 2001. Prospective analyses followed a group of respondents who were not unemployed at baseline across four subsequent years and investigated whether baseline mental health was associated with subsequent unemployment.

Results

Baseline mental health status was a significant predictor of overall time spent unemployed for both men and women. Decomposing this overall effect identified sex differences. For women but not men, baseline mental health was associated with risk of experiencing any subsequent unemployment whereas for men but not women mental health was associated with the duration of unemployment amongst those who experienced unemployment.

Conclusions

By following a group of respondents who were not unemployed over time, we showed that poor mental health predicted subsequent unemployment. On average, men and women who experienced symptoms of common mental disorders spent greater time over the next 4 years unemployed than those with better mental health but there were sex differences in the nature of this effect. These findings highlight the importance of mental health in the design and delivery of employment and welfare policy.

Keywords

Employment Mental health Health selection 

References

  1. 1.
    Dooley D, Fielding J, Levi L (1996) Health and unemployment. Annu Rev Public Health 17:449–465PubMedCrossRefGoogle Scholar
  2. 2.
    Fryers T, Melzer D, Jenkins R (2003) Social inequalities and the common mental disorders. Social Psychiatry Psychiatr Epidemiol 38:229–237CrossRefGoogle Scholar
  3. 3.
    Wilhelm K, Mitchell P, Slade T et al (2003) Prevalence and correlates of DSM-IV major depression in an Australian national survey. J Affect Disord 75:155–162PubMedCrossRefGoogle Scholar
  4. 4.
    Kessler RC, Zhao S, Blazer DG et al (1997) Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. J Affect Disord 45:19–30PubMedCrossRefGoogle Scholar
  5. 5.
    Jenkins R, Lewis G, Bebbington P et al (2003) The National Psychiatric Morbidity Surveys of Great Britain—initial findings from the Household Survey. Int Rev Psychiatry 15:29–42PubMedCrossRefGoogle Scholar
  6. 6.
    Graetz B (1993) Health consequences of employment and unemployment: longitudinal evidence for young men and women. Soc Sci Med 36:715–724PubMedCrossRefGoogle Scholar
  7. 7.
    Heponiemi T, Elovainio M, Manderbacka K et al (2007) Relationship between unemployment and health among health care professionals: health selection or health effect? J Psychosom Res 63:425–431PubMedCrossRefGoogle Scholar
  8. 8.
    Dooley D, Prause J, Ham-Rowbottom KA (2000) Underemployment and depression: longitudinal relationships. J Health Soc Behav 41:421–436PubMedCrossRefGoogle Scholar
  9. 9.
    Arrighi HM, Hertz-Picciotto I (1994) The evolving concept of the healthy worker survivor effect. Epidemiology 5:189–196PubMedCrossRefGoogle Scholar
  10. 10.
    Mossakowski KN (2009) The influence of past unemployment duration on symptoms of depression among young women and men in the United States. Am J Public Health 99:1826–1832PubMedCrossRefGoogle Scholar
  11. 11.
    Stankunas M, Kalediene R, Starkuviene S et al (2006) Duration of unemployment and depression: a cross-sectional survey in Lithuania. BMC Public Health 6:174PubMedCrossRefGoogle Scholar
  12. 12.
    Wooden M, Watson N (eds) (2002) The household, income and labour dynamics in Australia (HILDA) survey: an introduction. University of Melbourne, MelbourneGoogle Scholar
  13. 13.
    Butterworth P, Crosier T (2004) The validity of the SF-36 in an Australian National Household Survey: demonstrating the applicability of the Household Income and Labour Dynamics in Australia (HILDA) Survey to examination of health inequalities. BMC Public Health 4:44PubMedCrossRefGoogle Scholar
  14. 14.
    Rumpf HJ, Meyer C, Hapke U et al (2001) Screening for mental health: validity of the MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard. Psychiatry Res 105:243–253PubMedCrossRefGoogle Scholar
  15. 15.
    Ware JE Jr, Gandek B (1998) Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. J Clin Epidemiol 51:903–912PubMedCrossRefGoogle Scholar
  16. 16.
    Mineka S, Watson D, Clark LA (1998) Comorbidity of anxiety and unipolar mood disorders. Annu Rev Psychol 49:377–412PubMedCrossRefGoogle Scholar
  17. 17.
    Krueger RF, Caspi A, Moffitt TE et al (1998) The structure and stability of common mental disorders (DSM-III-R): a longitudinal-epidemiological study. J Abnorm Psychol 107:216–227PubMedCrossRefGoogle Scholar
  18. 18.
    Bartley M, Owen C (1996) Relation between socioeconomic status, employment, and health during economic change, 1973–93. Br Med J 313:445–449CrossRefGoogle Scholar
  19. 19.
    Hammarstrom A, Janlert U (2003) Unemployment–an important predictor for future smoking: a 14-year follow-up study of school leavers. Scand J Public Health 31:229–232PubMedCrossRefGoogle Scholar
  20. 20.
    Artazcoz L, Benach J, Borrell C et al (2004) Unemployment and mental health: understanding the interactions among gender, family roles, and social class. Am J Public Health 94:82–88PubMedCrossRefGoogle Scholar
  21. 21.
    Dalgard O, Dowrick C, Lehtinen V et al (2006) Negative life events, social support and gender difference in depression. Soc Psychiatry Psychiatr Epidemiol 41:444–451PubMedCrossRefGoogle Scholar
  22. 22.
    Leach LS, Christensen H, Mackinnon AJ et al (2008) Gender differences in depression and anxiety across the adult lifespan: the role of psychosocial mediators. Soc Psychiatry Psychiatr Epidemiol 43:983–998PubMedCrossRefGoogle Scholar
  23. 23.
    Hayes A, Gray M, Edwards B (2008) Social inclusion: origins concepts and key themes. Australian Institute of Family Studies, prepared for the Social Inclusion Unit, Department of the Prime Minister and Cabinet, CanberraGoogle Scholar
  24. 24.
    beyondblue. Work Outcomes Research and Cost Benefit (WORC) Project. http://www.beyondblue.org.au/index.aspx?link_id=4.75
  25. 25.
    beyondblue. National Workplace Progam. http://www.beyondblue.org.au/index.aspx?link_id=4.1028
  26. 26.
    Department of Education, Employment and Workplace Relations (2008) The future of disability employment services in Australia. Discussion paper. Commonwealth of Australia, CanberraGoogle Scholar
  27. 27.
    Australian Department of Health and Ageing. Better outcomes in mental health care program. http://www.health.gov.au/internet/mentalhealth/publishing.nsf/Content/better-outcomes-mental-health-care-1
  28. 28.
    UK Health Department. Improving access to psychological therapies program. http://www.dh.gov.uk/en/Healthcare/Mentalhealth/Psychologicaltherapies/index.htm
  29. 29.
    Bartley M (1994) Unemployment and ill health: understanding the relationship. J Epidemiol Community Health 48:333–337PubMedCrossRefGoogle Scholar
  30. 30.
    Leach LS, Butterworth P, Strazdins L et al (2010) The limitations of employment as a tool for social inclusion. BMC Public Health 10:621PubMedCrossRefGoogle Scholar
  31. 31.
    Butterworth P, Gill S, Rodgers B, Anstey KJ, Villamil E, Melzer D (2006) Retirement and the mental health of older Australians: analysis of the National Survey of Mental Health and Wellbeing. Soc Sci Med 62:1179–1191PubMedCrossRefGoogle Scholar
  32. 32.
    Olesen SC, Butterworth P, Rodgers B (2011) Is poor mental health a risk factor for retirement? Findings from a longitudinal population survey. Soc Psychiatry Psychiatr Epidemiol (in press)Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Peter Butterworth
    • 1
  • Liana S. Leach
    • 1
  • Jane Pirkis
    • 2
  • Margaret Kelaher
    • 2
  1. 1.Centre for Mental Health ResearchThe Australian National UniversityCanberraAustralia
  2. 2.Centre for Health Policy, Programs and EconomicsThe University of MelbourneMelbourneAustralia

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