The association between work type/status and mental health care use, before and during the economic recession in Europe

Studies have examined the relationship between socioeconomic determinants and mental health care use. However, to date, little research has investigated whether these relations have changed over time and vary across socioeconomic structures and gender. Between 2005 and 2010, a global economic crisis changed Europe’s economic situation, with economic instability and rising unemployment rates as a result. Recent research has found that in several countries, the recession has increased the frequency of mental health problems particularly among families experiencing unemployment. The fear generated by the increased chance of unemployment, which may depend on type of job, is also associated with poor mental health. Despite the greater demand for mental health care, there is a risk that austerity may impact adversely on health care provision. We have investigated the relation between unemployment, type of job and mental health and medical mental health care use in 2005 and 2010. By using the repeated cross-sectional data of the Eurobarometer 248 (2005-2006) and 345 (2009-2010), we have performed gender differentiated multilevel logistic regression analyses. Preliminary results suggest that compared to 2005, the average mental health status in Europe is worse in 2010 and the percentage that contacted a GP is higher, while in contrast, specialized care use is lower. Only unemployed women in 2005 have a higher general care use, irrespective of mental health. Contrastingly, in 2010 the unemployed men and women are more likely to contact a psychiatrist, also when we control for need for care. For men, this relation is stronger in countries with a lower unemployment rate. In addition, we found that male manual workers are in 2010 more likely to contact a psychiatrist than white collars and that the male self-employed have a lower general care use than the manual workers and white collars, both irrespective of mental health