The Institutional Foundations of Medicalization: A Cross-national Analysis of Mental Health and Unemployment

In this study, we question whether the relationship between unemployment and mental health care use, controlling for mental health status, varies across European countries. And whether these differences are patterned by a combination of unemployment and health care generosity. We hypothesize that medicalization of unemployment is stronger in countries where a low level of unemployment generosity is combined with a high level of health care generosity. A subsample of 36,306 working-age respondents from rounds 64.4 (2005–2006) and 73.2 (2010) of the cross-national survey, Eurobarometer, is used. Country-specific logistic regression and multilevel analyses, controlling for public disability spending, changes in government spending, economic capacity, and unemployment rate, are performed. We find that in the majority of the 24 nations, unemployment is medicalized at least to some degree. Moreover, the medicalization of unemployment varies substantially across countries, corresponding to the combination of the level of unemployment and of health care generosity.status: publishe