Impact of unemployment on mental disorders, physical health and quality of life: Findings from the Singapore Mental Health Study

Introduction: This study examines: (1) the employment rate among those with a mental disorder in the 12 months preceding the survey (referred henceforth as 12-month mental disorder); (2) the socio-demographic correlates of unemployment; and (3) the association of unemployment with 12-month mental disorders and chronic physical conditions in the adult resident population in Singapore. Methods: Data are from the Singapore Mental Health Study 2016, a household survey of a nationally representative sample of 6,126 Singapore residents. The Composite International Diagnostic Interview (CIDI) was used to assess mental disorders and physical health conditions. Employment-related information was collected using a modified employment module of the CIDI. Results: Of the 6,125 participants who took part in the study, 4,055 (72%) were employed, 1,716 (22.7%) were economically inactive, and 354 (5.3%) were unemployed. The unemployment rate was twice as high among those with a 12-month mental disorder (11.5%) than those without (4.8%). The proportion of unemployed individuals increased sharply with the increasing severity of mental disorders. Being married and higher household income were significantly associated with a higher likelihood of being employed than unemployed. In contrast, the presence of one 12-month mental disorder was significantly associated with a lower likelihood of being employed. Conclusion: Our findings provide information on the significant association of mental disorders with unemployment. Clinicians should remain vigilant and consider the loss of employment a potential risk factor for adverse physical and mental health changes. Management of unemployed patients with a combination of pharmacotherapy and work-directed interventions can facilitate their re-entry into the workforce and improve health outcomes.