Lost in transition: a systematic review of the association between unemployment and mental health

Abstract

Background

Unemployment can involve financial strain and major psychosocial challenges. Integration of the existing evidence is needed to better characterize the association between unemployment and mental health, independently of macroeconomic contexts.

Aims

Main objectives of this study: (a) review, integrate, and summarize evidence about the association between unemployment and anxiety disorders, mood disorders, and suicidal behaviour, and (b) identify variables affecting this association.

Method

Systematic review of literature following PRISMA guidelines. PubMed, Web of Science, SciELO, RCAAP, and Cochrane Library databases were searched. Quantitative empirical studies on the association between unemployment and mental illness of community-based samples were included. The quality of the evidence provided in the studies was assessed following pre-defined methodological criteria.

Results

Overall, 294 articles were considered eligible. In total, 55.7% of the studies were conducted in Europe; 91.4% supported a positive association between increased unemployment rates and anxiety, mood disorders, or suicidal behavior. Men and young adults were most severely affected by unemployment. Education and social support were found to buffer the negative outcomes of job loss.

Conclusions

Unemployment was inversely associated with mental health irrespectively of the economic context; unemployed individuals were more vulnerable to commit suicide and suffer from anxiety and mood disorders.

Keywords:

• Unemployment
• anxiety
• mood disorders
• suicide
• systematic review

Acknowledgements

The authors thank Inês Almeida, Tatiana Marques, and Tânia Fernandes for their help as team members of the Healthy Employment project.

Disclosure statement

The authors declare that they have no conflict of interest.

Data availability statement

All the data relating to this study are available within the manuscript and the datasets are provided as supplemental online material.

Additional information

Funding

This project was granted by the Public Health Initiatives Programme (PT06), funded by EEA Grants Financial Mechanism 2009–2014 (ref. 222SM2). The writing of the manuscript was also supported by funds from Fundação para a Ciência e a Tecnologia to ISAMB (ref. UIDB/04295/2020).