October 17, 2012

expert reaction to research into mental health trends through the 2008 recession

Men have borne the brunt of worsening mental health across the population of England since the start of the economic downturn in 2008, according to research published in BMJ Open based on the national representative annual Health Survey for England for adults aged 25 to 64, between 1991 and 2010.

Dr Paul Keedwell, Clinical Lecturer in the Neurobiology of Mood Disorders
and Honorary Consultant Psychiatrist at MRC Centre for Neuropsychiatric Genetics and Genomics, said:

“This large study has found evidence that the economic crash of 2008 led to a deterioration in mental health in men of working age. Researchers at the Social & Public
Health Sciences Unit in Glasgow looked at survey data from over 100,000 men and women before and after the crash. They used an established questionnaire for measuring the likelihood of having a mental disorder such as anxiety and depression in the general population. Interestingly, no deterioration was seen in women – a novel finding. Also, surprisingly, poor mental health was not related to unemployment rates.

“In general, males derive much of their esteem from occupational success and on average they are still the main wage earners in families. The poor mental health in males might have been driven by the stress of job insecurity rather than job loss. However, the authors concede that inevitable cuts in mental health services during a recession might also be to blame. In addition, the delayed consequences of unemployment (such as divorce and loss of home) may not have been captured by the time window of this study.

“The number returning their surveys decreased over time. Those who dropped out might have been the most affected by the recession.

“In conclusion, the study provides valuable snaphots of a community’s mental health in the short transition from boom to bust. It suggests that men are most adversely affected. However, studies such as this can not provide evidence of underlying causes and other follow-up studies should provide further insights.”

Prof Justine Schneider, Professor of Mental Health and Social Care, University of Nottingham, said:

“It’s long been recognised that the impact on mental health of job insecurity is worse than that of joblessness, these recent analyses confirm that the threat of unemployment is in itself harmful.  When people lose their jobs they react in different ways; some people thrive and this offsets the average impact.  Young people however are particularly badly affected by unemployment, which seems to reduce their self-esteem and increase the risk of depression.”

Prof Nick Manning, Director of the Institute of Mental Health, University of Nottingham, said:

“This finding does not surprise me. A 15 year project we conducted looking at the impact of rapid economic re-structuring in Russia since 1994 demonstrated a similar pattern – men who found themselves without their jobs and the prospect of new work were less able to cope than women. They suffered a catastrophic rise in morbidity and mortality. One model which explained this was that women were able to transfer networking skills that they had already displayed under the old system for survival then, to survival under the new economic system. Men thereby lost self esteem both at work and in the home. Findings are reported in  Health and Healthcare in the New Russia (2009)(edited by Nick Manning and Nataliya Tikhonova), Ashgate.”

Dr Amy Chandler, Research Fellow, Centre for Research on Families and Relationships University of Edinburgh, said:

“Some of the findings of the study by Katikireddi and colleagues are relatively unsurprising – that recession leads to a decline in mental health. This new analysis provides further support to theories that suggest that men – more than women – might be affected negatively by unstable job markets and rising prices.

“An interesting addition to current knowledge is the authors’ finding that this decline in mental health was also apparent among men who were employed, whereas previously much has been made of the association between unemployment and poor mental health among men. This suggests that there should be acknowledgement that recession can impact negatively upon men in general, whether in employment or not.

“The findings lend support to theories that suggest men are more invested than women in their job as a source of identity and ‘masculine pride’. Thus, instability in the labour market, threat or actual loss of a job, is experienced more keenly by men, with consequently greater impact on reported mental ill health.

“Although women are frequently characterised as being more equal to men in terms of employment, it remains the case that women are more likely than men to work part-time, are more likely to have other roles (e.g. child care), and still earn on average less money than men (see Fawcett Society). This reflects societal expectations regarding men and women’s roles which can have a negative impact on the mental health of both men and women. It is increasingly recognised that the negative impacts for men are often tied to changes and instability in employment – this study adds an important qualification to this, regarding the declining mental health of men in employment in times of recession.

“The authors do a good job of highlighting the limitations of the study – and it is especially good to see them note that it is possible that women’s mental health may decline more in years to come as changes are implemented which might more directly impact the lives of women.

“The study highlights the need to account for and attempt to mediate worsening mental health in times of recession. This can be challenging for many reasons, not least that many service providers face funding cuts in times of economic hardship. Indeed, findings from the study indicate the need for greater service provision, particularly services set up to cater for the needs of men, in times of economic hardship.”

‘Trends in population mental health before and after the 2008 recession: a repeat cross-sectional analysis of the 1991-2010 Health Surveys of England’ by Katikireddi et al is to be published in BMJ Open on Wednesday 17 October 2012.