Employment Vulnerability of People With Severe Mental Illness |
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| Authors: | Akissi S. Diby Pascale Lengagne Camille Regaert |
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| Affiliation: | 1. Lille Economie Management, CNRS UMR 9221, Lille University, Lille, France;2. Institute for Research and Information in Health Economics (IRDES), 117 bis rue Manin, Paris, France;1. Hospices Civils de Lyon, 162 Avenue Lacassagne, 69424, Lyon Cedex 03, France;2. Public Health Department, Health Economic Evaluation Service, University Hospital of Lyon, Health Services and Performance Research (HESPER) EA 7425, F-69008, Lyon, France;3. McMaster University, CRL Building, Rm. 208, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada;4. Department of Clinical Epidemiology & Biostatistics, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada;5. Faculté de Pharmacie - Université Lyon 1, 8 Avenue Rockefeller, 69373, Lyon Cedex 08 France;6. Lyon 1 Claude Bernard University, Health Services and Performance Research (HESPER) EA 7425, Léon Bérard Cancer Centre, F-69008, Lyon, France;1. Department of Economics, University of Otago, Dunedin, New Zealand;2. 1000minds Ltd, Wellington, New Zealand;3. Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand;1. Department of Information Management, National Chung Cheng University, Taiwan;2. School of Business and Public Administration, University of Guam, Mangilao, GU, 96923, Guam;3. Faculty of Education, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong;1. Department of Medical Informatics, Middle East Technical University, METU Informatics Institute, Universiteler Mahallesi, Dumlupinar Bulvari, No:1, 06800, Ankara, Turkey;2. Department of Management Information Systems, Ankara Medipol University, Faculty of Economics, Administrative and Social Sciences, Haci Bayram Mahallesi, Talatpasa Bulvari, No:2, Ankara, Turkey;3. Department of Science and Technology Policy Studies, Middle East Technical University, Universiteler Mahallesi, Dumlupinar Bulvari, No:1, MM Building 3rd Floor No: 320, 06800, Ankara, Turkey |
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| Abstract: | Using French longitudinal register data, we compare the evolution of employment rates of persons with severe chronic mental illness, before and after the first medico-administrative recognition of the illness by the Statutory Health Insurance (SHI), with that of people without recognised mental illness. The study focuses on persons of working age having a work history before recognition. Our empirical approach relies on a double difference method with coarsened exact matching. Before illness recognition subjects had lower employment rates than those without mental illness but relatively high, reflecting their initial employment attachment. Results indicate that employment rates decrease sharply after recognition. A large employment rate gap between persons with and without severe mental illness develops during the four years following recognition. We examine whether the magnitude of the decrease is sensitive to the macroeconomic context. Findings show that the decline in employment rates was significantly more pronounced during the Great Recession compared with the pre-crisis period, amongst women. As a conclusion, this study points out that implementing coordinated early health and labour policies in the phase of the entry into the chronic-illness insurance scheme of the SHI might play a key role in preventing the detrimental effects of illness on economic and social conditions of persons with severe mental illnesses. |
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| Keywords: | Severe mental illnesses disabled employment gap macroeconomic context France |
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