Effectiveness of community interventions for protecting and promoting the mental health of working-age adults experiencing financial uncertainty: a systematic review

Abstract

BackgroundThe COVID-19 pandemic has created a period of global economic uncertainty. Financial strain, personal debt, recent job loss and housing insecurity are important risk factors for the mental health of working-age adults. Community interventions have the potential to attenuate the mental health impact of these stressors. We examined the effectiveness of community interventions for protecting and promoting the mental health of working-age adults in high-income countries during periods of financial insecurity.MethodsEight electronic databases were systematically screened for experimental and observational studies published since 2000 measuring the effectiveness of community interventions on mental health outcomes. We included any non-clinical intervention that aimed to address the financial, employment, food or housing insecurity of participants. A review protocol was registered on the PROSPERO database (CRD42019156364) and results are reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsFrom 2326 studies screened, 15 met our inclusion criteria. Five categories of community intervention were identified: advice services colocated in healthcare settings; link worker social prescribing; telephone debt advice; food insecurity interventions; and active labour market programmes. In general, the evidence for effective and cost-effective community interventions delivered to individuals experiencing financial insecurity was lacking. From the small number of studies without a high risk of bias, there was some evidence that financial insecurity and associated mental health problems were amenable to change and differences by subpopulations were observed.ConclusionThere is a need for well-controlled studies and trials to better understand effective ingredients and to identify those interventions warranting wider implementation.

The Role of Unemployment, Financial Hardship, and Economic Recession on Suicidal Behaviors and Interventions to Mitigate Their Impact: A Review

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Mental Health Inequalities During COVID-19 Outbreak: The Role of Financial Insecurity and Attentional Control

“…Moreover, the acute phase of the present crisis, and its long-term consequences, tend to show that the disruption of mental health must be regarded as a significant threat. Community interventions may also address the mental health inequalities issue, but need more evidence-based studies (see McGrath et al, 2021 for a review). As suggested by Ridley et al (2020), future interventions to limit the negative impact of the COVID-19 pandemic and its direct consequences are much needed, and financial insecurity seems to be an important variable to include as suggested by the present research.…”

The Acceptability and Initial Effectiveness of “Space From Money Worries”: An Online Cognitive Behavioral Therapy Intervention to Tackle the Link Between Financial Difficulties and Poor Mental Health

“…Research has evaluated the impact of Cognitive Behavioral Therapy (CBT) in those who are unemployed, with mixed results about effectiveness ( 32 ). There has also been some research on community based interventions such as debt advice, social prescribing and labor market programmes, however there is not much evidence about the impact of this on mental health ( 33 ). Internet-delivered CBT (iCBT) has been shown by several meta-analyses to be effective for symptoms of depression and anxiety ( 34 – 38 ), and represents a way to increase access to psychological interventions.…”