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The impact of employment programs on common mental disorders: A systematic review

Research output: Contribution to journalReview articlepeer-review

Libby Evans, Crick Lund, Alessandro Massazza, Hannah Weir, Daniela C. Fuhr

Original languageEnglish
Pages (from-to)1315-1323
Number of pages9
JournalInternational Journal of Social Psychiatry
Volume68
Issue number7
Early online date7 Jul 2022
DOIs
Accepted/In press9 May 2022
E-pub ahead of print7 Jul 2022
PublishedNov 2022

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Publisher Copyright: © The Author(s) 2022.

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Abstract

Background: While employment programs were not created with the intent to improve common mental disorders (CMDs), they may have a positive impact on the prevalence, incidence, and severity of CMD by reducing poverty and increasing access to economic mobility. Aim: To examine and synthesize the available quantitative evidence of the impact of employment programs on outcomes of CMD. Methods: Embase, Econlit, Global Health, MEDLINE, APA PsychINFO, and Social Policy and Practice were searched for experimental and quasi-experimental studies which investigated the impact of employment programs on primary and secondary outcomes of a CMD. A narrative synthesis according to Popay was conducted. The methodological quality of studies was assessed with the Cochrane Risk of Bias tool and the Newcastle-Ottawa Assessment Scale. Results: Of the 1,327 studies retrieved, two randomized controlled trials, one retrospective cohort, one pilot study with a non-randomized experimental design, and one randomized field experiment were included in the final review. Employment programs generally included multiple components such as skills-based training, and hands-on placements. Depression and anxiety were the CMDs measured as primary or secondary outcomes within included studies. Findings regarding the impact of employment programs on CMD were mixed with two studies reporting significantly positive effects, two reporting no effects, and one reporting mixed effects. The quality among included studies was good overall with some concerns regarding internal validity. Conclusion: Employment programs may support a decrease in the prevalence, incidence, and severity of CMDs. However, there is high heterogeneity among study effects, designs, and contexts. More research is needed to gain further insight into the nature of this association and the mechanisms of impact. This review highlights the potential for employment programs and other poverty-reduction interventions to be utilized and integrated into the wider care, prevention, and treatment of common-mental disorders.

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