Trajectories in mental health and socio-spatial conditions in a time of economic recovery and austerity: A longitudinal study in England 2011–17 (original) (raw)
The impact of austerity on mental health
2018
This is a discussion paper which examines the impact of austerity policies on the provision of mental health services in the United Kingdom. Austerity is a shorthand for a series of policies introduced by the Conservative and Liberal Democrat Coalition government in the UK from 2010 onwards. In response to the fiscal crisis following the bail out of the banks in 2008, it was argued that significant reductions in public spending were required. The background to these policies is examined before a consideration of their impact on mental health services. These policies had a disproportionate impact on people living in poverty. People with health problems including mental problems are overrepresented in this group. At the same time, welfare and community services are under increasing financial pressures having to respond to increased demand within a context of reduced budgets. There is increasing recognition of the role that social factors and adverse childhood experiences have in the d...
The Impact of Austerity on Mental Health Service Provision: A UK Perspective
International Journal of Environmental Research and Public Health
This is a discussion paper which examines the impact of austerity policies on the provision of mental health services in the United Kingdom. Austerity is a shorthand for a series of policies introduced by the Conservative and Liberal Democrat Coalition government in the UK from 2010 onwards. In response to the fiscal crisis following the bail out of the banks in 2008, it was argued that significant reductions in public spending were required. The background to these policies is examined before a consideration of their impact on mental health services. These policies had a disproportionate impact on people living in poverty. People with health problems including mental problems are overrepresented in this group. At the same time, welfare and community services are under increasing financial pressures having to respond to increased demand within a context of reduced budgets. There is increasing recognition of the role that social factors and adverse childhood experiences have in the development and trajectory of mental health problems. Mental health social workers, alongside other professionals, seek to explain mental distress by the use of some variant of a biopsychosocial model. The extent of mental health problems as a one of their measures of the impact of inequality. More unequal societies create greater levels of distress. There is a social gradient in the extent of mental health problems-the impact of severe mental illness means that many individuals are unable to work or, if they can return to work, they find it difficult to gain employment because of discrimination. The paper concludes that austerity and associated policies have combined to increase the overall burden of mental distress and marginalisation within the UK.
This study explores the impact of involuntary unemployment at a time of economic recession on people’s everyday life and mental well-being. It explores the relation between people’s experiences of unemployment and two sets of resilience factors: coping strategies and practical and emotional support. The study consisted of 16 focus groups with 73 unemployed people in a ‘transition phase’ in the job market: young people (aged 18–25) who recently entered the job market and older workers (aged 50–65) closer to retirement age. The report covers the following questions: • What has been the impact of job losses on people’s everyday lives and well-being? • What have been the experiences and views of help and support from family, friends and formal services? • What practice and policy recommendations are there to promote mental well-being and resilience during economic downturns?
www.jrf.org.uk Mental health, resilience and the recession in Bradford
2011
How personal coping strategies and financial support help to moderate the impact of unemployment at a time of economic recession in Bradford. This study explores the impact of involuntary unemployment at a time of economic recession on people’s everyday life and mental well-being. It explores the relation between people’s experiences of unemployment and two sets of resilience factors: coping strategies and practical and emotional support. The study consisted of 16 focus groups with 73 unemployed people in a ‘transition phase ’ in the job market: young people (aged 18–25) who recently entered the job market and older workers (aged 50–65) closer to retirement age. The report covers the following questions: • What has been the impact of job losses on people’s everyday lives and well-being? • What have been the experiences and views of help and support from family, friends and formal services? • What practice and policy recommendations are there to promote mental well-being and resilien...
The effect of non-standard employment on mental health in Britain
2000
We examine the impact of moving home, the distance moved and reasons for moving on both household income and labour market earnings for a representative sample of individuals using panel data. Our results suggest that there are monetary returns to migration which apply to both household income and labour market earnings. However, not all migrants enjoy these returns, which depend on distance moved, family structure, and the employment situation of other family members. Further, returns to migration may not be enjoyed for some time after the move, emphasising the need for panel data in studies of residential mobilty. Using data that are too recent relative to the time of migration will yield misleading results and underestimate the size of the premium attributable to residential mobility.
Mental health and poverty in the UK - time for change?
BJPsych international, 2015
Poverty and income inequality have increased in the UK since the 1970s. Poverty and mental ill-health are closely associated and disadvantage can have long-term consequences. In addition, the recent recession and austerity measures have had a detrimental effect on people with mental health problems and the mental health of the population. Mental health services can play a role in addressing the problems of poverty and inequality.
Mental Health Beyond Austerity: A 'Mental Wealth' approach to post-austerity policy-making
The proposals in this document arose out of preparatory work by the four authors for the TUC ‘Closing the Gap’ conference in Salford as well as contributions by participants at the event. The manifesto in Appendix I represents some very preliminary ideas and suggestions towards a mental w/health manifesto, but does not claim to be a comprehensive statement nor represent the position of any particular organization or campaign. However, if there is a wish amongst wider mental w/health campaigns to do so, the authors are open to further discussions to develop this in democratic, collaborative and inclusive ways into a post-austerity Mental Health/Wealth Manifesto to inform ongoing activism.
BMJ Open
ObjectivesTo assess whether the direction of movement along the social gradient was associated with changes in mental health status.DesignLongitudinal record-linkage study using a multistate model.SettingCaerphilly, Wales, UK between 2001 and 2015.ParticipantsThe analytical sample included 10 892 (60.8% female) individuals aged 18–74 years.Primary and secondary outcome measuresDeprivation change at lower super output area level using the 2008 Welsh Index of Multiple Deprivation. Mental health was assessed in 2001 and 2008 using the Mental Health Inventory subscale of the short-form 36 V.2.ResultsMental health selection was shown whereby individuals with common mental health disorders were less likely to move to areas of lower deprivation but more likely to move to areas of greater deprivation.ConclusionPoor mental health seems to drive health selection in a similar way to poor physical health. Therefore, funding targeted at areas of higher deprivation should consider the demand to b...
Longitudinal and Life Course Studies
Despite an increase in living standards and material comforts in industrialised societies, today's 'emerging adults' (aged from late teens to mid-to-late 20s) face greater challenges than ever before. The aim of this paper is to explore the relationship between labour market status and mental health for the 'millennial generation' in England, and whether it varies by gender and ethnicity. This study will be the first to draw on the results from the 2015 sweep of Next Steps data when the sample members are aged 25 and, together with the previous seven sweeps, bring the debate up to date by providing first estimates of the life condition of contemporary emerging adults. We find black and minority ethnic groups have lower odds of reporting mental ill-health at age 25 than the white group. With respect to labour market status, we find that net of socioeconomic characteristics, educational attainment, behavioural variables and income at age 25, those who are unemployed are more than twice as likely to report symptoms of poor mental health as those who are employed. Shift workers and those on zero-hours contracts are also at a greater risk of mental ill-health by 47% and 44% respectively than those who are not shift workers or zero-hours workers. We find no significant difference for those who have a second job or are on a permanent contract for mental health at age 25 compared to those who do not have a second job or are on a temporary contract.
A longitudinal analysis of mental health mobility in Britain
Health Economics, 2004
This paper is concerned with quantifying the level of mental health mobility in the British Household Panel Survey (BHPS). We investigate whether the extent of mobility is different across categories of socio-economic groups such as income quintiles, educational attainment and social class group. Our measure of mental health is the 12-item version of the General Health Questionnaire (GHQ) that serves as a self-administered screening test aimed at detecting psychiatric disorders among respondents in community and non-psychiatric settings. Using eleven waves of the BHPS and a variety of methods we show there is much mobility in mental health from one wave to the next. Further the extent of mobility varies across socio-economic categories with greatest persistence observed in more disadvantaged groups. In general, these groups suffer poorer mental health and experience more prolonged periods of ill-health.
Socio-economic factors linked with mental health during the recession: a multilevel analysis
International Journal for Equity in Health, 2017
Background: Periods of financial crisis are associated with higher psychological stress among the population and greater use of mental health services. The objective is to analyse contextual factors associated with mental health among the Spanish population during the recession. Methodology: Cross-sectional, descriptive study of two periods: before the recession (2006) and after therecession (2011-2012). The study population comprised individuals aged 16+ years old, polled for the National Health Survey. There were 25,234 subjects (2006) and 20,754 subjects (2012). The dependent variable was psychic morbidity. Independent variables: 1) socio-demographic (age, socio-professional class, level of education, nationality, employment situation, marital status), 2) psycho-social (social support) and 3) financial (GDP per capita, risk of poverty, income per capita per household), public welfare services (health spending per capita), labour market (employment and unemployment rates, percentage of temporary workers). Multilevel logistic regression models with mixed effects were constructed to determine change in psychic morbidity according to the variables studied. Results: The macroeconomic variables associated with worse mental health for both males and females were lower health spending per capita and percentage of temporary workers. Among women, the risk of poor mental health increased 6% for each 100€ decrease in healthcare spending per capita. Among men, the risk of poor mental health decreased 8% for each 5-percentage point increase in temporary workers. Conclusions: Higher rates of precarious employment in a region have a negative effect on people's mental health; likewise lower health spending per capita. Policies during periods of recession should focus on support and improved conditions for vulnerable groups such as temporary workers. Healthcare cutbacks should be avoided in order to prevent increased prevalence of poor mental health.
Recession, recovery and suicide in mental health patients in England: time trend analysis
British Journal of Psychiatry, 2019
BackgroundThe 2008 economic recession was associated with an increase in suicide internationally. Studies have focused on the impact in the general population with little consideration of the effect on people with a mental illness.AimsTo investigate suicide trends related to the recession in mental health patients in England.MethodUsing regression models, we studied suicide trends in mental health patients in England before, during and after the recession and examined the demographic and clinical characteristics of the patients. We used data from the National Confidential Inquiry into Suicide and Safety in Mental Health, a national data-set of all suicide deaths in the UK that includes detailed clinical information on those seen by services in the last 12 months before death.ResultsBetween 2000 and 2016, there were 21 224 suicide deaths by patients aged 16 or over. For male patients, following a steady fall of 0.5% per quarter before the recession (quarterly percent change (QPC) 200...
Journal of Public Mental Health
Purpose -The purpose of this paper is to examine the preventable harm created by the adoption of austerity measures in 2010, added to the welfare reforms introduced in 2008 which, collectively, have negative implications for population mental health in the UK. Design/methodology/approach -A critical reflection of published research papers and key policy documents in this area. Findings -Negative mental health consequences of the combined impact of welfare reforms and austerity measures in the UK since 2010 are identified when relating to disability benefit assessments, and to the increased punitive conditionality applied to disability benefit claimants, as those in greatest need now live in fear of making a claim for financial support from the state or of losing benefits to which they are entitled.
Common mental disorders, unemployment and welfare benefits in England
Public Health, 2010
Anxiety Work Unemployment Benefits Debt s u m m a r y Objectives: Individuals who are out of work have a higher rate of common mental disorders (CMD) than individuals who are employed. People who are unemployed in the UK are entitled to welfare benefits to alleviate financial strain. This study examined rates of CMD in individuals who were employed, unemployed and receiving various UK benefits. It also investigated associations between duration of unemployment, gender and CMD. Study design: An analysis of 5090 working-age participants from the Adult Psychiatric Morbidity Survey 2007, a stratified probability sample survey conducted among adults aged 16 years and over living in private households in England.
The British Journal of …, 2006
BACKGROUND: Individuals in lower socio-economic groups have an increased prevalence of common mental disorders. AIMS: To investigate the longitudinal association between socio-economic position and common mental disorders in a general population sample in the UK. METHOD: Participants (n=2406) were assessed at two time points 18 months apart with the Revised Clinical Interview Schedule. The sample was stratified into two cohorts according to mental health status at baseline. RESULTS: None of the socio-economic indicators studied was significantly associated with an episode of common mental disorder at follow-up after adjusting for baseline psychiatric morbidity. The analysis of separate diagnostic categories showed that subjective financial difficulties at baseline were independently associated with depression at follow-up in both cohorts. CONCLUSIONS: These findings support the view that apart from objective measures of socio-economic position, more subjective measures might be equally important from an aetiological or clinical perspective.
Actions to alleviate the mental health impact of the economic crisis
World Psychiatry, 2012
"The current global economic crisis is expected to produce adverse mental health effects that may increase suicide and alcohol-related death rates in affected countries. In nations with greater social safety nets, the health impacts of the economic downturn may be less pronounced. Research indicates that the mental health impact of the economic crisis can be offset by various policy measures.This paper aims to outline how countries can safeguard and support mental health in times of economic downturn. It indicates that good mental health cannot be achieved by the health sector alone. The determinants of mental health often lie outside of the remits of the health system, and all sectors of society have to be involved in the promotion of mental health. Accessible and responsive primary care services support people at risk and can prevent mental health consequences. Any austerity measures imposed on mental health services need to be geared to support the modernization of mental health care provision. Social welfare supports and active labour market programmes aiming at helping people retain or re-gain jobs can counteract the mental health effects of the economic crisis. Family support programmes can also make a difference. Alcohol pricing and restrictions of alcohol availability reduce alcohol harms and save lives. Support to tackle unmanageable debt will also help to reduce the mental health impact of the crisis. While the current economic crisis may have a major impact on mental health and increase mortality due to suicides and alcohol-related disorders, it is also a window of opportunity to reform mental health care and promote a mentally healthy lifestyle."