EPA guidance on mental health and economic crises in Europe

Abstract

This European Psychiatric Association (EPA) guidance paper is a result of the Working Group on Mental Health Consequences of Economic Crises of the EPA Council of National Psychiatric Associations. Its purpose is to identify the impact on mental health in Europe of the economic downturn and the measures that may be taken to respond to it. We performed a review of the existing literature that yields 350 articles on which our conclusions and recommendations are based. Evidence-based tables and recommendations were developed through an expert consensus process. Literature dealing with the consequences of economic turmoil on the health and health behaviours of the population is heterogeneous, and the results are not completely unequivocal. However, there is a broad consensus about the deleterious consequences of economic crises on mental health, particularly on psychological well-being, depression, anxiety disorders, insomnia, alcohol abuse, and suicidal behaviour. Unemployment, indebtedness, precarious working conditions, inequalities, lack of social connectedness, and housing instability emerge as main risk factors. Men at working age could be particularly at risk, together with previous low SES or stigmatized populations. Generalized austerity measures and poor developed welfare systems trend to increase the harmful effects of economic crises on mental health. Although many articles suggest limitations of existing research and provide suggestions for future research, there is relatively little discussion of policy approaches to address the negative impact of economic crises on mental health. The few studies that addressed policy questions suggested that the development of social protection programs such as active labour programs, social support systems, protection for housing instability, and better access to mental health care, particularly at primary care level, is strongly needed.

Trends in gender and socioeconomic inequalities in mental health following the Great Recession and subsequent austerity policies: a repeat cross-sectional analysis of the Health Surveys for England

“…This study adds to what the European Psychiatric Association in 2016 described as an emerging ‘broad consensus about the deleterious consequences of economic crises on mental health’ 44. The gender gap in mental health, which had been improving prior to the recession, appears to be sharply widening again following the onset of austerity policies which have largely focused on women.…”

Economics and mental health: the current scenario

“…On the other hand, economic disadvantage is associated with a greater likelihood of mental illness, possibly through greater exposure to risk factors (e.g., social exclusion) and poorer access to protective factors (e.g., education), or a complex downward spiral (e.g., entanglement of poverty, treatment costs, employment difficulty; the so‐called “drift” hypothesis). The European Psychiatric Association recently issued guidance on mental health and economic crises in Europe, based on a review of 350 articles, highlighting the need for policy approaches to tackle the complex, sizeable impacts.…”

Mortality from Suicide in the Municipalities of Mainland Portugal: Spatio-Temporal Evolution between 1980 and 2015

“…8,21,22 Para além do exposto, em contextos de crise, os efeitos tendem a agravar-se, aumentando as situações de vulnerabilidade e desigualdade, e, consequentemente, o risco e a mortalidade por suicídio. [23][24][25] Evidência científica tem revelado associações entre suicídio e características que acompanham períodos de crise e austeridade, com destaque para a perda de estatuto socioeconómico, o empobrecimento, o desemprego, os despejos e o endividamento. 14,[26][27][28][29][30][31][32] Em Portugal, vários estudos geraram evidência sobre a associação entre a mortalidade por suicídio e as características dos territórios de vivência dos indivíduos, à escala do continente (município) 33 e das áreas metropolitanas (freguesia), 34,35 nomeadamente em tempos de crise económica e financeira.…”