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08_chap_8.Rmd
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---
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# Conclusion {#chapter8}
This work aimed to investigate the relationship between common mental disorders, severe mental illness, and economic activity in England. It provides a detailed understanding of the patterns of economic activity among individuals with common mental health disorders severe mental illness and how these vary by both individual and local labour market characteristics.
The APMS is a nationally representative survey of households in England that collects information on the prevalence and characteristics of mental health disorders in adults. The survey is conducted by the National Centre for Social Research (NatCen) and is commissioned by NHS Digital. The survey uses a face-to-face interview and a self-completion questionnaire to gather data on a range of mental health disorders, including common mental disorders such as depression and anxiety, and severe mental illness such as schizophrenia and bipolar disorder. The APMS also collects data on a range of socio-demographic characteristics, including age, gender, education, and employment status. The survey is conducted every seven years, with the most recent wave of data being collected in 2014. The APMS data is a valuable resource for researchers and policymakers as it provides a detailed understanding of the prevalence and characteristics of mental health disorders in the general population. It was a good choice for this work because it provides a comprehensive picture of the prevalence of mental health conditions in the general population and the factors associated with them, as well as its ease of access in light of working within the context of COVID-19. After data cleaning and restricting the samples to England only and capping the age at 74 to bring the 2000 and 2007 waves into line with each other, there were 7,247 individuals in the 2000 APMS survey wave, and 6,453 individuals in the 2007 survey wave.
Despite the increasing prevalence of poor mental health worldwide, work concentrating on severe mental illness in particular is less prevalent than work looking into common mental health disorders. Potential reason could be the complexity and diversity of severe mental illness, which can make it more difficult to study and understand in relation to employment. Additionally, there may be a lack of data on severe mental illness and employment due to the stigma and discrimination that individuals with severe mental illness often face, which can make it difficult for them to access and maintain employment. Furthermore, many individuals with severe mental illness may not be in the workforce, which can make it harder to collect data on their employment status. Finally, there may be fewer resources and funding streams dedicated to studying the relationship between severe mental illness and employment compared to common mental health disorders and employment, which can limit the amount of research conducted in this area. This all leads to a lack of good quality data available for analysis. The APMS study fills the gap in the current literature by providing detailed insights into the relationship between common mental disorders and severe mental illness and employment status in England. It provides a comprehensive understanding of how patterns of employment vary by individual and local labour market characteristics, and how this relationship has changed since 2000 in England.
The work also aimed to address the following research questions:
1. How has the impact of common mental health disorders and severe mental illness on employment status changed since 2000 in England?
2. How do employment status patterns for individuals with common mental health disorders and severe mental illness compared to the rest of the population in England in 2007?
3. Is the relationship of severe mental illness to employment status different from the relationship of common mental health disorders to employment status in England?
4. How does living with common mental health disorders and severe mental illness affect the entrance of young adults (16-35 years old) to the labour force, in comparison to young adults without common mental health disorders and severe mental illness?
5. Are the effects of common mental health disorders and severe mental illness on employment status mitigated or exacerbated by other barriers or enablers, such as socioeconomic status, ethnicity, education, physical health, involvement in services?
Results found that the impact of common mental health disorders and severe mental illness on employment status in England has changed since 2000 (RQ1). Specifically, the study found that there has been an increase in the number of individuals with common mental health disorders and severe mental illness who are unemployed or inactive in the labour market. Furthermore, the study found that the relationship between common mental health disorders and severe mental illness and employment status is complex and influenced by a number of demographic, social, and economic factors, including age, gender, education, and socioeconomic status. The study also found that the impact of common mental health disorders and severe mental illness on employment status is affected by changes in the labour market and the availability of support and resources for individuals with mental illnesses.
Findings showed that individuals with common mental disorders and severe mental illnesses were less likely to be employed compared to the rest of the population in England in 2007 (RQ2). Results from logistic regression models showed that having a common mental health disorders or severe mental illness was negatively associated with employment and that this association was statistically significant. Additionally, treatment used for common mental health disorders, including the use of mental health services and medication, was also found to negatively impact employment outcomes. Specific types of common mental health disorders and severe mental illness were also found to have a negative effect on economic activity, with psychosis conditions having a greater negative impact than personality disorders. Overall, the study highlights the need for society to invest in policies and programs that support individuals with mental illnesses in finding and keeping employment.
We also found that having a common mental disorder or severe mental illness was negatively associated with employment in both the 2000 and 2007 survey waves (RQ3). The study found that the negative effect of common mental health disorders on economic activity was stronger in the 2007 survey wave. The study also found that treatment use, including the use of mental health services and medication, was negatively associated with employment for individuals with common mental health disorders. However, the effect of using counseling services alone on employment was not statistically significant in the 2007 survey wave. Additionally, specific types of common mental health disorders and severe mental illness were found to have a negative impact on economic activity, with psychosis being more statistically significant than personality disorders in both survey waves. Overall, it appears that the relationship of severe mental illness on employment status is similar to the relationship of common mental health disorders on employment status in England (RQ1).
Results show that young adults living with common mental health disorders and severe mental illness were less likely to be employed and participate in the labour force, compared to their peers without mental health conditions (RQ4). The study used logistic regression models to examine the relationship between common mental health disorders and severe mental illness and economic activity while controlling for demographic, health, and educational factors. The results showed that having a common mental health disorders or severe mental illness was negatively associated with employment and that this association was statistically significant in both survey waves. Additionally, the study found that treatment use for common mental health disorders and severe mental illness also had a negative effect on employment outcomes. Overall, the study found that living with common mental health disorders and severe mental illness can have a significant impact on the entrance of young adults to the labour force.
We found that the effects of common mental disorders and severe mental illnesses on employment status are influenced by other factors such as socioeconomic status, ethnicity, education, physical health, and involvement in services (RQ5). Results from logistic regression models applied to the 2000 and 2007 survey waves showed that factors such as being female, having a physical health condition, being of older age, and having lower levels of education were negatively associated with employment. On the other hand, being skilled or having higher levels of education were positively associated with employment. Additionally, the study found that treatment used for common mental health disorders, including use of mental health services and medication, was negatively associated with employment. The study also found that certain types of common mental health disorders and severe mental illness were associated with a decreased likelihood of being economically active. Moreover, the study found that individual's socioeconomic status, ethnicity, education, physical health, and involvement in services can act as barriers or enablers that can mitigate or exacerbate the effects of common mental health disorders and severe mental illness on employment status.
In conclusion, the APMS study provides valuable insights into the relationship between common mental health disorders and severe mental illness and employment status in England. The study aimed to examine how the impact of common mental health disorders and severe mental illness on employment status has changed since 2000, to compare the employment status patterns of individuals with common mental health disorders and severe mental illness to the rest of the population in England in 2007, to determine if the relationship of severe mental illness on employment status is different from the relationship of common mental health disorders on employment status, and to explore how living with common mental health disorders and severe mental illness affects the entrance of young adults to the labour force. The study also highlights the importance of considering other barriers and enablers in addition to common mental health disorders and severe mental illness, such as socioeconomic status, ethnicity, education, physical health, and involvement in services.
The results of the study indicate that individuals with common mental health disorders and severe mental illness are less likely to be employed compared to the general population. The study also found that treatment use for common mental health disorders and severe mental illness is negatively associated with employment, which may suggest that the severity of the condition is an important factor in determining employment outcomes. Furthermore, the study found that specific types of common mental health disorders, such as depression, generalised anxiety and depression, and mixed anxiety and depression, were associated with a decreased likelihood of being economically active.
Additionally, the study found that other factors, such as gender, age, education, and physical health, also play a role in determining employment outcomes for individuals with common mental health disorders and severe mental illness. Specifically, the study found that being female and aged 55-74 years old were negatively associated with economic activity. Additionally, higher levels of education were positively associated with employment. These findings highlight the importance of considering the intersectionality of various factors in determining employment outcomes for individuals with common mental health disorders and severe mental illness.
However, it is important to note that this study has some limitations. The data used in the study is cross-sectional, which means that it does not allow for the examination of causality or temporal relationships between common mental health disorders and severe mental illness and employment status. Additionally, the study relies on self-reported data, which may be subject to bias. Further research using more robust and longitudinal data would be beneficial in understanding the relationship between common mental health disorders, severe mental illness, and employment status.
Overall, the work contributes to a better understanding of the complexity of the relationship between common mental health disorders, severe mental illness and employment status, and the importance of considering other factors that may interact with these conditions in determining employment outcomes. The findings of this study have important implications for policymakers, healthcare providers, and individuals living with common mental health disorders and severe mental illness as it also provides a platform for further research and development of policies and interventions that aim to support and empower individuals living with common mental health disorders and severe mental illness to improve their employment outcomes. The findings of this study are a crucial step towards addressing the employment disparities faced by individuals living with common mental health disorders and severe mental illness and promoting greater inclusivity and equity in the workforce.