152 lines
5.1 KiB
YAML
152 lines
5.1 KiB
YAML
abstract: 'Background: Research examining mental health outcomes following economic
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downturns finds both pro-cyclic and countercyclic associations.
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Pro-cyclic findings (i.e. economic downturns correspond with decline in
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illnesses) invoke increase in leisure time and risk-averse behavior as
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underlying drivers of reduction in harmful consumption during economic
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recessions. By contrast, counter-cyclic evidence (i.e. economic
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downturns correspond with increase in illnesses) suggests increase in
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mental illness with economic decline owing to heightened stress and loss
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of resources. particularly among certain age and socioeconomic groups.
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Aim of the Study: To examine the relation between monthly aggregate
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employment decline and psychiatric emergency department visits across 96
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counties within 49 Metropolitan Statistical Areas in the United States.
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Methods: For this study, data on all psychiatric outpatient Emergency
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Department (ED) visits for 4 US states (Arizona, California, New Jersey
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and New York) were retrieved from the State Emergency Department
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Database (SEDD) and aggregated by county-month, for the time period of
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2006 to 2011. Exposure to recession was operationalized as
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population-level employment change in a Metropolitan Statistical Area
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(MSA). This information was obtained from MSA-level employment provided
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by the US Bureau of Labor Statistics. Brief exposure time lags of 0 to 3
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months were specified to estimate proximate responses to MSA-level
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economic decline. Income level was approximated based on insurance
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status (private insurance= high-income, public insurance = low-income).
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Linear regression analysis was used to test whether monthly decline in
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aggregate employment in an MSA corresponds with (i) changes in
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population rates of psychiatric ED visits and (ii) whether the relation
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between the outcome and exposure varies by insurance status (private,
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public) and age group (children. age < 20 years; working-age adults, age
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20 to 64 years; elderly adults, age > 64 years). Regression methods
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controlled for region. year and month fixed effects, and state-specific
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linear time trends.
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Results: Linear regression results indicate that overall, psychiatric ED
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visits (per 100,000 population) decline with decline in monthly
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employment at exposure lag 0 (coefficient: 0.54, p < 0.001) and lag 2
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(coefficient: 0.52, p < 0.001). Privately insured (high-income) groups
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also show a decline in psychiatric ED visits following decline in
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aggregate employment. Conversely, publicly insured children show an
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increase in psychiatric ED visit rates one month (i.e. lag 1) following
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employment decline (coefficient: -0.35, p value < 0.01). Exploratory
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analyses by disorder groups show that the population-level decline in
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psychiatric ED visits concentrates among visits for alcohol use
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disorders at 0, 1 and 2 month lags of employment decline.
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Discussion: This study''s findings provide evidence of pro- as well as
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counter-cyclic trends in psychiatric emergency visits following
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aggregate employment decline in an MSA. Whereas declines in psychiatric
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emergencies support a risk-averse response to economic recessions, these
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aggregate trends may mask countervailing trends among vulnerable groups.
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Limitations of this study include the absence of sex-specific analyses
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and lack of information on emergent or non-emergent nature of
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psychiatric ED visits.
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Implications for Health Care Provision and Use: Psychiatric ED visits
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during recessions may vary by age and income groups.
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Implications for Health Policies: Findings from this study may serve to
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develop targeted policies for low-income groups during macroeconomic
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downturns.
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Implications for Further Research: Future research may examine trends in
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emergent versus non-emergent psychiatric ED visits following economic
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recessions.'
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affiliation: 'Singh, P (Corresponding Author), Univ Calif Irvine, Program Publ Hlth,
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Anteater Instruct \& Res Off AIRB, 653 E Peltason Dr Suite 2010,2nd Floor, Irvine,
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CA 92697 USA.
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Singh, Parvati, Univ Calif Irvine, Program Publ Hlth, Anteater Instruct \& Res Off
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AIRB, 653 E Peltason Dr Suite 2010,2nd Floor, Irvine, CA 92697 USA.'
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author: Singh, Parvati
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author-email: parvatis@uci.edu
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author_list:
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- family: Singh
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given: Parvati
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da: '2023-09-28'
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eissn: 1099-176X
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files: []
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issn: 1091-4358
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journal: JOURNAL OF MENTAL HEALTH POLICY AND ECONOMICS
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keywords-plus: 'MENTAL-HEALTH-SERVICES; GREAT RECESSION; TIME-SERIES; UNEMPLOYMENT;
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ANTECEDENTS; DISPARITIES; DEPRESSION; ACT'
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language: English
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month: MAR
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number: '1'
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number-of-cited-references: '66'
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pages: 13-30
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papis_id: e43e63e7ad9e9c23fc7f2df56673c80e
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ref: Singh2021psychiatricemergenci
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times-cited: '0'
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title: 'Psychiatric Emergencies Following the 2008 Economic Recession: An Ecological
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Examination of Population-Level Responses in Four US States'
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type: article
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unique-id: WOS:000626637300003
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usage-count-last-180-days: '0'
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usage-count-since-2013: '1'
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volume: '24'
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web-of-science-categories: Health Policy \& Services; Psychiatry
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year: '2021'
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