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The role of economic policy
In the mid-1980s, Stephen Platt published two reviews of the literature that indicated that unemployment was associated with an increased risk of completed suicide and an increased risk of attempted suicide (sometimes referred to as parasuicide).1,2 As we have pointed out, the association between unemployment and suicidal behaviour seems to be more reliable at the individual level than at the aggregate level.3 For example, in time series studies of 14 nations with available data for the period 1950–1985, Lester and Yang found a positive association between unemployment and completed suicide rates in only 10 nations, and this association was statistically significant in only four nations.4
The article by Tony Blakely and his colleagues in this issue of the journal provides excellent support for the association between unemployment and completed suicide at the individual level.5 The use of national records in a single country for over 2 million 18–64 year olds provides a sample far greater than samples used in previous research, and the inclusion of control variables makes the conclusions of the study more meaningful.
For future research, there are several issues that need to be addressed. Firstly, the discrepancy between the results of studies at the individual level and at the aggregate level needs to be addressed. Why do time series studies of unemployment and suicide rates fail to find a consistent association, an inconsistency found also in cross sectional studies over, for example, regions within a county? This discrepancy between the results of what we have called macrosocionomic and microsocionomic research designs6 is common to many phenomena in the social and behavioural sciences and raises difficult problems for sociological theories.
Secondly, the role of mental health in the association between unemployment and suicidal behaviour needs to be explored further. Does unemployment increase the risk of serious psychiatric problems that in turn increase the risk of suicidal behaviour or, alternatively, are those with psychiatric problems more likely to become unemployed and also more likely to engage in suicidal behaviour?
Ezzy has noted, in his review of the association between unemployment and mental health, that unemployment does not always result in worse mental health.7 Indeed, a minority of people show an increase in psychological wellbeing once they become unemployed. For which people does unemployment have a deleterious impact (including an increased risk of suicidal behaviour) and for which people does it have a beneficial impact?
Blakely and his colleagues in their article in this issue, using indirect methods, argue that about half of the increased risk of death from suicide is attributable to the mediating role of the increased level of mental illness. Eventually, the issue of the role of mental illness in the association between unemployment and suicidal behaviour can be resolved only by a study of people who receive adequate psychiatric evaluations while employed and subsequently when unemployed, together with appropriate control groups.
The association between unemployment and suicidal behaviour also raises another issue, one concerning public policy decisions. At the present time, before construction projects are approved by governments (local and national), environmental impact statements are demanded and, if the environmental impact is considered to be too harmful, the project may be delayed and even forbidden. Threatening the extinction of a rare species or introducing toxic chemicals into the local environment are the kinds of impacts that can thwart a project.
Economic decisions made by local and national governments apparently have an impact on people. In the present instance, unemployment seems to lead to an increased mortality from suicide. It is clear, therefore, that economic policy decisions made by governments (or by their designated decision makers such as the Federal Reserve Bank in the USA) can have a tremendous impact on the population. We have suggested that those making such decisions should prepare formal “impact” statements in the same way that developers and construction companies are required to do.8 A focus on solely economic issues may suggest particular actions for public policy makers, while consideration of the psychological and social impact of those actions may change these decisions. Indeed, many European nations have regulations in place preventing companies from laying off employees during hard financial times for the companies, and the Employment Committee of the House of Commons in the United Kingdom has requested memoranda from social scientists concerning the psychological impact of unemployment in order to help them make appropriate decisions.9 This should become more common, and it would provide an important role for social scientists in future public policy decisions.
The role of economic policy
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