Scottish Longitudinal Study
Development & Support Unit

Current Projects

Project Title:

Mental Health and Employment Retention in Scotland

Project Number:



Serena Pattaro (ADRC-S/University of Glasgow)
Nick Bailey (University of Glasgow)
Chris Dibben (ADRC-S/University of Edinburgh)

Start Date:

1st March 2018



The background to the study is the broad policy concern with rising employment rates for those with long-term illness or disability and reducing the number of people who lose employment following the onset of a health problem.

Research has demonstrated that the experience of unemployment is among the key determinants of health and wellbeing, with both material and psychosocial pathways (Bambra, 2011; Lundberg et al., 2014). Loss of employment and the associated loss of income have both been shown to be associated with an increase in morbidity and mortality (Bartley et al., 2006; Sullivan and von Wachter, 2009).

A large body of evidence shows that unemployment and material deprivation negatively impact upon mental health (depression, anxiety), suicides and suicide attempts (Hollander et al., 2013; Flint et al. 2013; Paul and Moser, 2009; Stuckler et al., 2009; Wilkinson and Pickett, 2009). On the other hand, an emerging body of empirical evidence reveals that people with health problems have a higher propensity to exit employment and then face longer spells of unemployment (Arrow, 1996; Stewart, 2001). Increased levels of stress and sleep difficulties may also contribute to  risky health behaviours, such as excess alcohol consumption and smoking, and harm from increased risk of traffic accidents, self-harm or heart conditions (Browning and Heinesen, 2012; Eliason and Storrie, 2009).

The proposed study seeks to contribute to the efforts of Scottish Government to develop predictive tools to identify the risk factors contributing to people dropping out of employment as a result of a mental health condition, in order that appropriate health interventions can be targeted to people identified at risk of job loss.


This study aims to investigate the relationship between mental health conditions and employment retention in Scotland. It forms the first stage of a larger project that will later use an innovative combination of Census data linked to prescribing data and data from the benefits system.

This study is intended to enhance our knowledge around the key risk factors contributing to employment retention among people affected by mental health conditions. It is also intended to provide an initial knowledge base, in synergy with plans by Scottish Government expert group to develop a more complex predictive analytics framework.

This proposal addresses the following research questions:

  • What are the factors associated with remaining in employment following the experience or onset of mental health problems?
    • How do they vary by individual characteristics such as age, level of qualifications, occupation or industry, household situation or nature of mental health problem?
    • How do retention rates vary by labour market context (e.g. local unemployment rate)?
    • What institutional factors – specifically, variations in the level or nature of local mental health services – make a difference to retention rates, and for which groups?
  • For those who lose employment, what factors are associated with movement into the long-term sick (inactive) category rather unemployment?


Arrow, J.O. (1996) Estimating the influence of health as a risk factor on unemployment: a survival analysis of employment duration for workers surveyed in the German Socio-Economic Panel, Social Science and Medicine, 42 (12): 1651-59.

Bambra, C. (2011) Work, worklessness, and the political economy of health. Oxford University Press.

Bartley, M., et al. (2006) Health and labour market disadvantage: unemployment, non-employment and job insecurity in M. Marmot and R. G. Wilkinson (eds) Social determinants of health (2nd edition), Chapter 5, 78-96, Oxford University Press.

Browning, M. and Heinesen, E. (2012) Effect of job loss due to plant closure on mortality and hospitalization, Journal of Health Economics, 31: 599-616.

Eliason, M and Storrie, D. Job loss is bad for your health – Swedish evidence on cause-specific hospitilization following involuntary job loss, Social Science & Medicine, 68: 1396-1406.

Flint, E., et al (2013) Do labour market status transitions predict changes in psychological well-being?, Journal of Epidemiology and Community Health, 65: 796-802.

Hollander, A.-C., et al. (2013) Hospitalisation for depressive disorder following unemployment-differentials by gender and immigrant status: a population-based cohort study in Sweden, Journal of Epidemiology and Community Health, 67: 875-81.

Lundberg, O., et al. (2014), The role of income and social protection for inequalities in health, evidence and policy implications. Final scientific report of DRIVERS Project. Stockholm: Centre for Health Equity Studies.

Paul, K. I. and Moser, K. (2009), Unemployment impairs mental health: meta-analyses, Journal of Vocational Behavior, 74: 264-82.

Stewart, J. (2001), The impact of health status on the duration of unemployment spells and the implications for studies of the impact of unemployment on health status, Journal of Health Economics 20 (5): 781-96.

Stuckler, D., et al. (2009) The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis, The Lancet 374 (9686): 315-23.

Sullivan, D. and von Wachter, T. (2009) Job displacement and mortality: an analysis using administrative data, Quarterly Journal of Economics, 124 (3): 1265-1306.

Wilkinson, R. G. and Pickett, K. E. (2009) Income inequality and social dysfunction, Annual Review of Sociology, 35: 493-511.

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