From Our 2010 Archives

Out of Work May Mean Out of Sorts

By Dennis Thompson
HealthDay Reporter

THURSDAY, Aug. 19 (HealthDay News) -- The economic downturn has put thousands of Americans out of work, but their bank accounts aren't the only things suffering as unemployment remains high and they struggle to find a job.

Surveys by Mental Health America and other researchers have found that people affected by the lousy economy have a higher risk for mental illness, especially such conditions as depression and anxiety.

The U.S. government has taken steps to help. Federal stimulus and jobs bills and unemployment benefit extensions helped some people cope with the effects of the bad economy. And new rules that took effect in July require that group health insurance policies offer the same level of coverage for mental health issues as for other medical or surgical issues.

The government also has promulgated rules to ensure that large businesses that choose to offer mental health and substance abuse benefits make them available at a level comparable to their existing medical insurance benefits.

David L. Shern, president and chief executive of Mental Health America, considers these important steps toward keeping Americans mentally healthy as they stand on the brink.

"We need to make sure we provide adequate social safety nets so that, although they will have their life strategy disrupted, their ability to meet basic needs will continue," Shern said.

The Mental Health America survey found that unemployed people were four times as likely as people with jobs to report symptoms consistent with severe mental illness.

But the harmful mental effects of the economy aren't limited to the unemployed. People whose jobs were changed by the economic downturn -- those who went through involuntary job changes or had their hours or pay cut at work -- were twice as likely to have symptoms consistent with severe mental illness, the survey found.

It also found that unemployed people were four times more likely to think of harming themselves and twice as likely to report substance or alcohol abuse or worries about their mental health.

"People are anxious and people are depressed," Dr. Nada Stotland, a psychiatry professor at Rush Medical College in Chicago, said of the current state of many Americans. "They're just very, very discouraged. They have trouble sleeping. They may have trouble eating, or they may stuff their mouths with whatever's flying past."

At a time when they need professional help more than ever, many people have less access to it, the survey also revealed. About half of the survey participants who were unemployed said they had difficulty obtaining health care. Of those who hadn't spoken to a doctor about their mental health concerns, 42% said it was because the care was too expensive or they didn't have insurance to cover it.

Stotland said she has seen this in her own practice. "What happens is not necessarily that people don't come in," she said. "It's a concern that they don't come in because they lose their insurance or don't have the money. I have two patients who are in that bind right now."

She said she's urged them to come in anyway, explaining that the financial issues can wait, but people often are reluctant to feel as if they're taking advantage or freeloading.

For those who do have health insurance, the government's new mental health parity rules might relieve some of the pressure. The rules require that group health insurance plans for businesses with more than 50 employees treat mental health benefits on a par with standard medical and surgical coverage in terms of out-of-pocket costs, benefit limits and plan management practices, according to the U.S. Department of Health and Human Services.

But unless unemployed people have access to COBRA, a program that offers continued coverage for a time in such situations, they may not benefit from the new rules.

However, Shern and Stotland noted steps that people who are unemployed can take to help care for their mental health, including:

  • Embracing the transformative possibilities of their new lives. "They can see this not as the catastrophic end of a lifelong plan to be successful, but more an opportunity to look at that plan, take a look at the world and be ready to take advantage of new opportunities that will eventually emerge," Shern said.
  • Making sure they stay connected with people. "When people are unemployed, they are going to lose that connection," he said. "They lose a very important social network that they had."
  • Finding pleasurable and relaxing pastimes that don't cost money. They could go for a walk, play with their kids or enjoy an old board game that's been gathering dust on a shelf. "Thinking about it, there are a lot of things to do," Stotland said. "There are all sorts of things you can do that you've been overlooking."
  • Eating right and exercising. Following a healthy lifestyle has been shown to promote mental wellness and decrease depression and anxiety, Shern said.

MedicalNewsCopyright © 2010 HealthDay. All rights reserved.

SOURCES: David L. Shern, Ph.D, president and chief executive, Mental Health America, Alexandria, Va.; Nada Stotland, M.D., M.P.H., professor, psychiatry, Rush Medical College, Chicago