Tackling the social costs of mental ill health

Gordon HaroldProfessor Gordon Harold is the Andrew and Virginia Rudd Professor of Child and Adolescent Mental Health in the School of Psychology at the University of Sussex.

Today the government launches its Improving Lives: Helping Workless Families policy paper, which aims to improve outcomes for children who grow up in workless families. A core emphasis of the report is on ESRC-funded research showing that children who experience acrimonious conflict between parents are at risk for multiple poor outcomes, including reduced mental health.

Here, Gordon highlights the role of social science in improving mental health research and the outcomes this can have on society.

Mental health is fundamentally the bedrock of a successful and productive society. Recent estimates (PDF) suggest that by the year 2020, depression will represent the second leading cause of time lost to illness. In 2015, mental health-related issues were found to lead to approximately 17.6 million days sick leave, or 12.7 per cent of the total sick days taken in the UK.

Poor mental health not only affects the quality of individual lives and wider society, but costs money. According to one estimate, the costs of mental health problems to the UK economy are £70–100 billion per year – 4.5 per cent of gross domestic product (GDP). Not only is it of interest to researchers and professionals to better understand the mental health problems that affect individuals’ quality of life; it is increasingly in the interest of policymakers.

The UK Government has previously acknowledged the important role that family relationships, particularly parenting plays in shaping mental health outcomes for young people. The Improving Lives: Helping Workless Families policy paper launched by the DWP today utilises an expanding body of UK and international research highlighting that the quality of the inter-parental relationship affects children’s mental health outcomes, and reduces the quality of parenting that children experience. Further, these processes are apparent whether parents are living together or not (married versus divorced), or whether parents are genetically related to their children or not (eg adoption, foster-care, assisted reproduction).

In this report, parents’ relationship quality (how parents/carers relate to each other) and associated impacts on parenting are highlighted as major influences on youth outcomes, including mental health and educational attainment – key indicators of future employability and long-term life chances. The report has a primary focus on how the inter-parental and parent-child relationships affect children’s mental health, particularly contexts of economic disadvantage.

Investing early in family relationship support, particularly inter-parental relationship support, will pay significant dividends in reducing poor individual life outcomes and societal costs, according to the primary recommendations of the report. Further, the publication harnesses a policy-linked, cost-benefit framework building on recommendations from researchers and practitioners highlighting that rather than representing single problems that operate in isolation of each other, early symptoms of mental health problems may ‘set the stage’ for a cascade of long-term outcomes and diminished life chances.iStock_000000429918Medium.jpg

To tackle this challenge from a policy and early intervention perspective, we need to distinguish between two primary realms of mental health problems: clinically discernible ‘psychiatric’ problems (eg ADHD, Schizophrenia, Alzheimer’s disease), and those that have early developmental features with more broad-based symptoms that may or may not develop into clinical illness. Early symptoms may be a marker for future serious psychological disorder, and identifying the causes of early problems (eg depression) is a first step to preventing long-term negative outcomes and lifespan costs.

It is more important than ever that accurate intervention targets for policy are highlighted, if the escalating rates of mental health problems and associated impacts on society are to be realistically (and sustainably) addressed. This objective serves as the primary focus of the Improving Lives: Helping Workless Families report.

Understanding where and how to intervene early to reduce the interplay between social disadvantage risk factors (such as family poverty and inter-parental conflict), individual mental health outcomes (such as anxiety or depression), and the accumulating ‘cascading effects’ within and across generations is the next step if we aim to break this chain of diminished individual life chances and associated societal costs.

Working in partnership with government we can maximise a knowledge-led investment model that transforms the life chances of individuals and promotes a ‘more’ (improved societal outcomes) for ‘less’ (early investment) model that can sustainably interrupt negative cascades and associated costs of poor mental health. Taking this next step with evidence-led guidance is essential – recognising the unparalleled resources of UK social science and our world-leading longitudinal studies.

ESRC continues to fund high-quality, policy-relevant research through its current mental health priority area.

Details of the ESRC-funded research referenced in the Improving Lives: Helping Workless Families report is available in the evidence base.

2 thoughts on “Tackling the social costs of mental ill health

  1. Pingback: Disadvantage and worklessness: a longitudinal perspective | ESRC blog

  2. Pingback: Top 10 ESRC blogs from 2017 | ESRC blog

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