Mental health outcomes in times of economic recession: a systematic literature review

Abstract

BackgroundCountries in recession experience high unemployment rates and a decline in living conditions, which, it has been suggested, negatively influences their populations’ health. The present review examines the recent evidence of the possible association between economic recessions and mental health outcomes.MethodsLiterature review of records identified through Medline, PsycINFO, SciELO, and EBSCO Host. Only original research papers, published between 2004 and 2014, peer-reviewed, non-qualitative research, and reporting on associations between economic factors and proxies of mental health were considered.ResultsOne-hundred-one papers met the inclusion criteria. The evidence was consistent that economic recessions and mediators such as unemployment, income decline, and unmanageable debts are significantly associated with poor mental wellbeing, increased rates of common mental disorders, substance-related disorders, and suicidal behaviours.ConclusionOn the basis of a thorough analysis of the selected investigations, we conclude that periods of economic recession are possibly associated with a higher prevalence of mental health problems, including common mental disorders, substance disorders, and ultimately suicidal behaviour. Most of the research is based on cross-sectional studies, which seriously limits causality inferences. Conclusions are summarised, taking into account international policy recommendations concerning the cost-effective measures that can possibly reduce the occurrence of negative mental health outcomes in populations during periods of economic recession.

The Great Recession and suicide

“…Most prior work and syntheses of evidence, including US studies, have argued that working age men have been most adversely affected [15][16][17]. In contrast, we found that the only age-gender groups that demonstrated excess deaths due to the recession were men aged 65 and over and women aged 15-24 years.…”

How do economic downturns affect the mental health of children? Evidence from the National Health Interview Survey

“…Similarly, area level measures of housing markets are related to mental health; previous analyses found suicide rates increased with state‐level foreclosure rates (Houle & Light, ). Evidence from a review of 100 papers shows that unemployment, income decline, and debts had significant associations with poor self‐reported mental health, increased rates of common mental disorders, increases in substance use disorders, and suicidal behaviors in adults (Frasquilho et al, ). In these adult populations, no matter how mental health was measured, changes in business cycles are correlated with changes in mental health.…”

Factors Associated With County-Level Differences in U.S. Drug-Related Mortality Rates

“…Economic disadvantages like unemployment, poverty, low education, and housing challenges are associated with increased risk of family conflict, social isolation, stress, and substance misuse. 17–22 Concentrated economic disadvantage can contribute to collective frustration and hopelessness, 23 out-migration, community disinvestments, and social disorders like substance misuse. 23–30 Therefore, counties with greater economic, housing, and family distress should have higher drug-related mortality rates.…”