Past unemployment may have a pervasive psychological impact that occurs across nations. We investigate the association between unemployment events across working life and subsequent psychological well-being across 14 European countries. Additionally, we consider the influence of between-country differences in labour market institutions and conditions on the cross-country well-being effects of unemployment. Data detailing life-long employment trajectories and contemporary life conditions are drawn from the Survey of Health, Ageing and Retirement in Europe. The well-being impact of unemployment is modeled using linear, multi-level specifications. Each six-month spell of past unemployment is found to predict reduced quality of life and life satisfaction after the age of 50, having adjusted for a broad range of individual and country-specific covariates. In contrast, the impact of past unemployment on depression is explained by individual demographic factors. We identify the first comparative long-term evidence that unemployment welfare scarring may be a broad, international phenomenon.
Rationale: Symptoms of mental health problems have been shown to predict adverse labour market outcomes including unemployment, but no studies have used sibling models to examine the relationship between clinically diagnosed psychiatric conditions in adolescence and subsequent unemployment. Objective: This study used extensive Swedish registry data to investigate the link between psychiatric conditions diagnosed during military conscription and unemployment over two decades. Further, we identified whether this relation was amplified during an economic downturn and tested whether it was affected by adjustment for unobserved family characteristics using sibling fixed-effects models. Method: Psychiatric conditions were diagnosed by psychologists and psychiatrists at military conscription in sample of 929,191 Swedish men (mean age = 18.4 years) between 1969 and 1989. The average number of days unemployed per year was observed from 1992 to 2012, using the records of the Swedish Public Employment Services. Results: After adjustment for physical health and childhood socioeconomic status those diagnosed with any psychiatric condition experienced approximately an additional 10 days per year unemployment compared to others. Alcohol (16 days unemployment) and other substance use disorders (17 days) were the strongest predictors of exposure to future unemployment, followed by personality disorders (10 days), neurotic and adjustment conditions (nine days), and depressive disorders (six days). Family background factors accounted for approximately half of the observed relationship between mental health conditions and unemployment. Psychiatric conditions interacted with macroeconomic conditions such that those with pre-existing alcohol-related, and neurotic and adjustment disorders were disproportionately more likely to become unemployed following the 1990s crisis in Sweden. Conclusions: Adolescent mental health conditions forecast an elevated risk of unemployment, which endures over the life course and is amplified in times of economic uncertainty. Investment in youth mental health services and alcohol and substance use prevention programs may yield economic benefits by reducing unemployment.
Background It is estimated that around 160,000 households in Britain experience homelessness each year, although no definitive statistics exist. Between March and September 2020, as part of the initial ‘Everyone In’ government response to COVID-19 in England, 10,566 people were living in emergency accommodation and nearly 18,911 people had been moved into settled accommodation. However, some forms of temporary accommodation may not be suitable as shared facilities make it impossible for people to adhere to government guidelines to reduce the spread of COVID-19. Methods This is parallel group, pilot randomised controlled trial. The target is to recruit three local authorities, each of which will recruit 50 participants (thus a total of approximately 150 participants). Individuals are eligible if they are aged 18 and over, in a single-person homeless household, temporarily accommodated by the LA with recourse to public funds. Participants will be randomised to receive settled accommodation (intervention group) or temporary accommodation (control group). The intervention group includes settled housing such as Private Rented Sector (low and medium support), Social Housing (low and medium support), and Housing First (High support). The control group will maintain treatment as usual. The follow-up period will last 6 months. The primary outcome is to assess the feasibility of recruitment, retention, and acceptability of trial processes against progression criteria laid out in a traffic light system (green: all criteria are met, the trial should progress as designed in this pilot; amber: the majority of criteria are met and with adaptations to methods all criteria could be met; red: the minority of criteria are met and the pilot RCT should not proceed). Secondary outcomes include assessment of completeness of data collection at 3 and 6 months and percentage of participants consenting to data linkage, as well as a process evaluation and economic evaluation. Discussion This trial will address feasibility questions associated with progression to a fully powered effectiveness trial of models of housing to reduce risk of COVID-19 infection and homelessness. Trial registration ISRCTN69564614. Registered on December 16, 2020.
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