Changes in Employment Situation and Macroeconomic Indicators Linked to Mental Health Following the Recession in Spain: A Multi-level Approach

Background: Periods of financial crisis are associated with higher psychological stress in the population and greater use of mental health services. This paper analyses the individual and contextual factors associated with mental health in the Spanish population in 2006, 2012 and 2017. Method: This was a cross-sectional, descriptive study at three timepoints: before (2006), during (2012) and after the recession (2017). The study population comprised individuals aged 16+ years old, polled for the National Health Survey. Dependent variable: psychiatric morbidity (PM). Independent variables: 1) Individual socio-economic variables: (socio-demographic and psycho-social variables) and 2) contextual socio-economic variables (financial, public welfare services and labour market indicators). Multilevel logistic regression models with mixed effects were constructed to determine changes in PM in relation to the variables studied. Results: Among women, the risk of PM increased when per capita health spending decreased and the percentage of temporary workers increased. The risk for men and women was lower when the employment rate decreased and the unemployment rate increased. Conclusions: It is possible that not only unemployment but also insecure employment entails a risk to mental health and that much of the employment created no longer guarantees basic levels of security it had achieved in previous decades.

Automated summary

This study analyzed individual and contextual factors associated with mental health in the Spanish population in 2006, 2012 and 2017, finding that the risk of psychiatric morbidity among women was linked to per capita health spending and the percentage of temporary workers, while the risk for men and women was affected by employment and unemployment rates.