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The relationship between mental health and employment : A systematic review of cohort studies

Héroufosse, Jenny
(2024)

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Heroufosse_50831800_2024.pdf
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Details

Supervisors
Pierre Smith
Faculty
Faculté de santé publique
Degree label
Master [120] en sciences de la santé publique, à finalité spécialisée
Abstract
Background: Knowledge of the bi-directional association between employment status and mental health is important, as it affects multiple dimensions of our daily lives, both at the individual and societal levels. Given that individuals’ mental health status and employment situation are likely to change over time, there is a significant need for longitudinal data to better understand causality patterns in this association and the underlying mechanisms. Therefore, this study aimed to perform a systematic review of existing cohort studies on the associations between employment status and mental health outcomes. Methods: A systematic review was carried out based on the PRISMA guidelines in 3 electronic databases: PubMed, Embase, and PsycInfo. Studies eligible for inclusion were cohort studies, involving the general population, and assessing the relationship between employment status and mental health longitudinally. Results: In total, 3,733 studies were identified and 36 met the inclusion criteria. The fourteen studies focusing on the social causation hypothesis highlighted the negative long-term impact of unemployment and unstable employment on mental health. Four studies observed mental health improvements upon re-entering employment, although limited and in more specific contexts. The eleven studies focusing on the health selection hypothesis found a lower probability for individuals with mental health problems in finding and maintaining employment. Finally, the eleven studies assessing the two hypothesis simultaneously found that mental health problems were both a consequence of and a risk factor for poor employment status, although some important moderating factors, such as gender differences, influence the direction and strength of the association. Conclusion: This review underscores the bi-directional association between the employment status and mental health of individuals, highlighting the need to develop targeted prevention (e.g. mental health support in the workplace) and intervention strategies (e.g. supported employment programs) in both the mental health and labor market systems.