Behavioral Health and the Economic Downturn

The deteriorating economy has already resulted in a significant rise in unemployment, both in the US and throughout the world. Research shows that job loss can have a devastating impact on mental health. Unemployment results in higher rates of depression, alcohol abuse, and suicide, as well as increases in psychiatric hospitalizations. Not surprisingly, many unemployed workers experience a significant loss of self-esteem, and begin to shift towards an “external locus of control,” the belief that outside factors control their lives. There is evidence that a number of groups, including older workers and those at risk for depression, are more likely to experience the negative effects of job loss.

The negative consequences of unemployment are not confined solely to those who have lost their jobs. Other family members, particularly children and adolescents, are adversely affected as well. Economically distressed families can become trapped in a vicious cycle. Continuing stress results in more emotional distress, greater marital discord, and less effective parenting. Not surprisingly, domestic violence tends to increase as a result of unemployment. Moreover, as shown by longitudinal studies, children of financially distressed families are more likely to show academic and behavior problems in school.

Even employees who do not lose their jobs may experience heightened stress. Once layoffs begin, those who remain often must assume responsibilities previously shouldered by departed co-workers, all the while worrying if they will be the next to lose their jobs.

Given the gloomy financial outlook for the near future, is there anything that we can do to mitigate the impact of an ailing economy on mental health?

Psychologists have known for many years that social support — from one’s peers, family, and community — can play a significant role in buffering the negative influence of stressful life events, including job loss. Research indicates that social support, particularly a specific type of support called “reassurance of worth” is especially helpful for those who are coping with unemployment. As the name implies, reassurance of worth involves acknowledging and valuing the skills and abilities of the unemployed.

Moreover, there is evidence that the unemployed benefit substantially if they participate in JOBS, a five-day structured workshop program developed by Dr. Richard Price, a psychologist from the University of Michigan, and several colleagues from around the world. The JOBS program aims to increase self-confidence and improve job-seeking skills. Randomized trials in both the US and Finland indicated that participation in the JOBS program resulted in greater success in finding new jobs and lower rates of depression among unemployed workers.

There are a number of steps that can be taken to reduce the adverse psychological effects on the ever-growing ranks of unemployed workers and their families. Many of these steps are straightforward and inexpensive to implement:

  • Since social support plays a key role in helping to reduce stress, health plans, employers, and other organizations with websites can organize bulletin boards where the unemployed (and their family members) can support one another, and provide information about other resources in their communities.
  • Employers who are planning layoffs can make the JOBS program or other outplacement services available to those who are losing their jobs.
  • Employers who cannot afford to offer face-to-face services for all those losing jobs can at least make video or audio podcasts of the outplacement programs available to them online.
  • Health plans and employers can step up screening and early interventions in their populations for behavioral health problems, particularly depression. Online behavioral health interventions, which are highly scalable and inexpensive to deploy, can be used to help prevent more serious problems from developing, and provide confidential help for those unwilling to come forward for treatment.