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Sunday, May 29, 2022

Unemployment, Behavioral Health, And Suicide

R. Ramchand, L. Ayer, & S. O'Connor
Health Affairs
Originally posted 7 APR 22

Key Points:
  • A large body of research, most of which is ecological, has investigated the relationship between job loss or unemployment rates and mental health, substance use, and suicide.
  • Groups historically experiencing health disparities (for example, Black and Hispanic populations and those without a high school or college degree) have been differently affected by unemployment during the COVID-19 pandemic. Similarly, preliminary evidence from three states suggests that suicide has disproportionately affected Americans who are members of racial and ethnic minority groups over the course of the pandemic.
  • COVID-19 has affected the workforce in unique ways that differentiate the pandemic from previous economic downturns. However, previous research indicates that increases in suicide rates associated with economic downturns were driven by regional variation in unemployment, availability of unemployment benefits, and duration and magnitude of changes in unemployment.
  • Policy mitigation strategies may have offset the potential impact of unemployment fluctuations on suicide rates during the pandemic. Policies include expanded unemployment benefits and food assistance, as well as tax credits and subsidies that reduced child care and health care costs.
  • Research is needed to disentangle which populations experienced the most benefit when these strategies were present and which had the greatest risk when they were discontinued.
  • Evidence-based strategies that expand the mental health workforce and integrate mental health supports into employment and training settings may be promising ways to help workers as they navigate persistent changes to workforce demands.

Suicide In The United States

A recent Health Affairs Health Policy Brief provides an overview of suicide in the United States. In 2019, 47,511 Americans intentionally ended their lives, making suicide the tenth leading cause of death. This is likely an underestimate—in 2019, 75,795 Americans died of poisonings, the majority of which were drug poisonings categorized as unintentional, although some were likely suicide overdoses that were misclassified.

Suicide is a growing national concern despite the fact that the national suicide rate decreased between 2018 and 2019 and again in 2020. This decrease comes after nearly twenty years of the national suicide rate increasing annually, and it was not observed in some minority racial and ethnic groups. In addition, although suicide rates decreased between 2018 and 2020, the drug overdose death rate increased.