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Mental health, employment status and parenthood: the impact of the economic downturn on portuguese youth mental health
Publication . Frasquilho, Diana; Caldas-de-Almeida, José M.; Matos, Margarida Gaspar de
ABSTRACT: Background: Economic recessions pose significant risks to individuals’ mental health and well-being. Common mental disorders are already highly prevalent in Europe, and more so in Portugal. Thus, changes in macroeconomic conditions are likely to aggravate this scenario. The exponential and rapid increase of unemployment is a particular consequence of the economic recession that has been proven to have a detrimental effect on mental health and well-being at both individual and population levels. These negative effects appear to be particularly related to the loss of financial protection and the loss of latent benefits that people had previous access through work (e.g. time structure, social contact, social status, collective purpose, and activity). Moreover, the effects of job loss on mental health seem to follow a chain-effect pattern, whereby unemployed parents and their children are both affected. Unemployed parents, who become distressed, may also have more difficulties in nurturing and taking care of their children. The changes in family relations may increase psychological maladjustment problems which may continue into adulthood impacting children’s future prospects.
Objectives: In this context, the aims of this research work were: 1) to clarify the associations between factors related to economic recession and mental health outcomes and to characterize the most vulnerable groups of the population; 2) to investigate the prevalence of psychological well-being and related factors in adult job seekers; 3) to explore how family life is affected by unemployment during the economic recession; 4) to identify parental unemployment associations with young people’s mental well-being and perceived repercussions of the economic recession.
Methods: This research work comprised of three phases. The first phase consisted of a systematic review of the current evidence relating to economic recessions, mental health outcomes and main vulnerability factors. In the second and third phases, research was conducted using two data sources: 1) cross-sectional survey data collected from unemployment benefit claimants from Lisbon (Portugal) in the context of economic recession, that was performed in five Lisbon civil parishes which contained specialized offices for professional integration of unemployed people; and 2) cross-sectional data from the Portuguese Health Behaviour in School-aged Children (HBSC/WHO) study, which is an epidemiological study focusing on health and well-being of students conducted quadrennially in collaboration with the World Health Organization (WHO) and coordinated by the principal investigator Professor Dr. Margarida Gaspar de Matos from the University of Lisbon. For the study of unemployed adults (phase 2), the sample comprised of 748 unemployment benefit claimants from Lisbon (52% males) with a mean age of 43 years old (±11.4), and a subsample of 112 unemployed mothers and fathers of adolescents (44% fathers) with a mean age of 45 years old (±6.6). The outcomes evaluated were mental well-being (General Health Questionnaire-12), life satisfaction (Cantril’s Self-Anchoring Ladder) and deprivation of latent (e.g. financial income) and manifest benefits (e.g. social contact, time structure, status, collective purpose, and activity) of work (LAMB-scale). This was followed by quantitative and qualitative questions related to family life and parental unemployment impacts on children in the context of an economic recession. For the study regarding young people living with unemployed parents (phase 3), there were two samples. The Portuguese HBSC 2010 study sample consisted of 4541 Portuguese adolescents (48% boys) attending 6th, 8th and 10th school grades and with a mean age of 14 years old (±1.3). The sample from the HBSC 2014 study consisted of 3152 Portuguese adolescents (47% boys) attending 8th and 10th school grades and with a mean age of 15 years old (±1.2). The outcomes evaluated across parental employment status were: subjective health complaints (HBSC Symptom Checklist), life satisfaction (Cantril’s Self-Anchoring Ladder), emotional well-being related to parents’ unemployment status, satisfaction with the family life and peer interactions, adolescents’ future and educational aspirations and experiences related to the economic crisis (Economic crisis repercussions scale). All data analyses for phase 2 and 3 were completed using Statistical Package for Social Sciences (SPSS v22.0), and the level of significance was set at p < 0.05.
Results: This research work resulted in a collection of eleven scientific papers that compose this thesis. The main findings suggested that: 1) economic recessions pose increased risks to mental health, and unemployed people and their family members are amongst the most affected group; 2) unemployed adults show a high prevalence of psychological distress and low life satisfaction, and the associations are stronger for unemployed women, older aged people, people with lower education, singles, partnered fathers and women living with unemployed partners; 3) worse mental health outcomes are more prevalent among unemployed adults that lack ability to purposefully structure their time and those who are financially deprived; 4) unemployment is associated with substantial cuts on household expenses that range from cutting on essential needs (house, food, health and children’s education expenses) to families’ leisure activities (holidays, going out, dining at restaurants), and is also associated with changes in family relations (more support vs. more friction and stricter parenting), parental distress (worry, anger, bad temper, and sadness) and perceived children’s low well-being (sadness, worry and bad temper); 5) young people living with unemployed parents report significantly worse mental well-being outcomes, lower future educational expectations, and perceive more the repercussions of the economic recession, than those living with employed parents; the main vulnerability aspects found were: paternal unemployment, low socioeconomic position, younger children, being a girl or older sons with unemployed fathers; 6) and finally, family relational factors may moderate the link between parental unemployment and young people’s mental well-being.
Conclusions: The findings from this present research work enhance our understanding of how the economic recession, and the unemployment situation in particular, may be affecting Portuguese job seekers and their children’s mental health and well-being, during the unique context of economic recession. Moreover, findings highlight the role of economic (income), noneconomic factors (e.g. time structure) and of family relations as factors that can act against the deleterious effects of unemployment on well-being. The identification of modifiable factors associated with better adult, family and children well-being during unemployment is essential given that Portugal faces an historical economic recession, has one of the highest unemployment rate in Europe, and tailored interventions to protect adults and young people’s well-being during unemployment are urgently required. Such interventions may maximize life opportunities, diminish future health inequality and social expenditure for countries, and are fundamental to achieving a healthier and productive society.
Mental health outcomes in times of economic recession
Publication . Frasquilho, Diana; Matos, Margarida Gaspar; Salonna, Ferdinand; Guerreiro, Diogo; Storti, Cláudia C.; Gaspar, Tânia; Caldas-De-Almeida, José M; JM, Caldas-de-Almeida; NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM); BioMed Central (BMC)
Background: Countries 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. Methods: Literature 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. Results: One-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. Conclusion: On 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.
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Fundação para a Ciência e a Tecnologia
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SFRH
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SFRH/BD/80846/2011