Unemployment, Behavioral Health, and Suicide

The unprecedented drop in employment that was seen at the start of the COVID-19 pandemic demands a thorough investigation of the complex relationship between job loss and suicide, as well as the public policies and interventions that may mitigate the distress associated with job loss.

What’s the Issue?

A large body of research has uncovered associations between job loss or unemployment rates and mental health, substance use, and suicide. An almost immediate consequence of the COVID-19 pandemic was a surge in American unemployment, which skyrocketed from under 5 percent to almost 15 percent in April 2020. This unprecedented unemployment spike warrants investigation into the complex relationship between job loss and mental health, and the public policies and interventions that may mitigate the impact of unemployment on suicide risk.

In many ways, suicide represents just one of many measures of population distress. Many of the unemployment-related factors that may increase suicide risk also affect other mental and behavioral health outcomes, like depression or hazardous drinking. Groups historically experiencing health disparities (e.g., Black and Hispanic populations and those without a high school or college degree) have been differently impacted by unemployment during the COVID-19 pandemic.

COVID-19 has impacted the workforce in unique ways that differentiate the pandemic from recessions in the past. However, previous research indicates that increases in suicide rates associated with economic downturns were driven by regional variation in job loss, availability of unemployment benefits, and duration and magnitude of changes in unemployment.

What’s Next

Establishing a causal relationship between job loss and other mental and behavioral health outcomes is difficult because mental health symptoms can also lead to loss of employment. There is evidence that those with serious psychological distress prior to the COVID-19 pandemic were at increased risk of job disruption during the pandemic.

Policy mitigation strategies may have offset the potential impact of unemployment fluctuations on suicide rates during the pandemic. Policies included expanded unemployment benefits and food assistance, as well as tax credits and subsidies that reduced child care and health care costs. Workplace supports such as flexible hours can help retain those with mental health conditions in the workforce. Finally, evidence-based interventions can reduce suicide risk, including various behavioral therapies; treatments for depression and anxiety; and pharmacologic therapies.

COVID-19 has led to historic disruptions in the nation’s workforce, which may impact suicide rates.  As more data become available, the relative impact on populations historically experiencing health disparities will be better understood. Preliminary evidence may suggest disproportionate increases in suicide rates during the pandemic among some racial/ethnic minority populations.

Suicide risk is complex, driven by both static and dynamic risk factors. Research that captures fluctuations in such factors over time can help illuminate who is at risk, in what window of time, and in relation to the presence/absence of which available supports. Research is needed to disentangle which populations experienced the most benefit from these support strategies, and which had the greatest risk when they were discontinued.