Common mental disorders, unemployment and psychosocial job quality: Is a poor job better than no job at all?

Employment is usually associated with health benefits over unemployment. However, an article published in Psychological Medicine by a group of researchers from Australia and the UK has shown that having a job with poor psychosocial quality can be as bad for mental health as being unemployed.

It is generally accepted that employment is associated with lower levels of psychiatric morbidity (illness) than unemployment and that as people move from unemployment into work their mental health improves. Research also shows that the psychosocial characteristics (those involving social and psychological behaviour) of work also influence health. In previous research, the authors have shown that transitions to high quality jobs lead to reduced psychological distress but that transitions from unemployment to the poorest psychosocial quality jobs actually leads to increased levels of distress. However, this previous research has not considered the experience of clinical mental disorders.

Analysis of data from the English Adult Psychiatric Morbidity Survey considered the prevalence of common mental disorders (CMDs) such as anxiety and depression amongst 2603 respondents aged between 21 and 54 years who were either i) employed or ii) unemployed and looking for work at the time of interview in 2007. Quality of work was assessed by the number of adverse psychosocial job conditions reported (low control, high demands, insecurity, and low job esteem).

The analysis showed that there was no difference in the rates of CMD between those who were unemployed and those who were in the poorest quality jobs. Both of these groups of individuals were more likely to experience a CMD than those who were in high quality work. This pattern remained evident after controlling for relevant demographic and socio-economic covariates.

Associate Professor Butterworth, lead author of the paper said, "While employment is thought to promote mental health and wellbeing, work of poor psychosocial quality is not associated with any better mental health than unemployment. Policy efforts to improve community mental health should consider psychosocial job quality in conjunction with efforts to increase employment rates."

He continued, "On a positive note, the current results suggest that good quality work is associated with lower rates of psychiatric disorders. This provides policy makers, coordinators of workplace programs, and employers with a potential tool or leverage point for improving mental health in the community. The improvement of psychosocial work conditions, such as reducing job demands, and increasing job control, security, and esteem can flow on to improvements in employee's mental health and reduce the burden of illness on public health systems."