J Epidemiol Community Health 59:243-249 doi:10.1136/jech.2004.019778
  • Research report

Employment transitions and mental health: an analysis from the British household panel survey

  1. Claudia Thomas1,
  2. Michaela Benzeval1,
  3. Stephen A Stansfeld2
  1. 1Department of Geography, Queen Mary, University of London, London, UK
  2. 2Centre for Psychiatry, Queen Mary, University of London
  1. Correspondence to:
 Dr C Thomas
 Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK;
  • Accepted 20 April 2004


Study objective: To describe the impact of changes between employment and various forms of non-employment, and vice versa, on the psychological wellbeing of men and of women.

Design: Separate multivariate models for men and for women were constructed to study the association between employment transitions and episodes of psychological distress (general health questionnaire).

Participants: 13 359 employment transitions from 5092 people aged 16–74 years in the British household panel survey from 1991 to 1998.

Main results: Transitions from paid employment to either unemployment or long term sick leave were associated with increased psychological distress for both men and women. Starting maternity leave or staying home to look after the family were also associated with psychological distress for women. Transitions from these roles to formal employment resulted in an improvement in mental health. There was some evidence that the effects were felt most strongly within six months of the transition.

Conclusions: This paper provides further evidence that movements between paid employment and various forms of non-employment, in addition to unemployment, have an impact on mental health. The emphasis on transitions between a full range of employment states for both men and women from a large population based longitudinal study and a comparison of the relative magnitude of effects are unique features of this analysis. Interventions are suggested to minimise the psychological distress associated with transitions.


  • * Full details concerning the design of the BHPS and the sampling strategy can be found in Taylor.13

  • For brevity the term “long term illness” in the data tables relates to the occurrence of the transition, “sick” relates to the derived indicator variable.

  • Tables of these results can be obtained from the authors if desired.

  • Funding: this project is funded by the Medical Research Council Health Services and Public Health Research Board’s Health of the Public Programme (strategic project grant number 51878).

  • Conflicts of interest: none declared.