The Foresight Mental Capital and Wellbeing Project (2008) claims that 420,000 UK employees are experiencing depression, anxiety or stress at levels that made them feel ill. This is in spite of a growth in workplace well-being
initiatives. One might be forgiven for thinking that work is intrinsically damaging to mental well-being. There is no doubt that work can be a source of hazards, and these have been extensively catalogued by the Health and Safety
Executive, and protection enshrined in legislation. In recent years this concept has been extended to psycho-social hazards, and methods of assessing them identified (e.g. Rick et al., 2001). There is strong evidence that psycho-social hazards in the workplace have consequences for physical as well as mental health. A case can be made that their management, although problematic, is an issue with implications for policy (Marmot, Siegrest & Theorell, 2006). The matter is complicated by conflict between work or career priorities and home life, which can be a (bi-directional) source of stress (Hughes & Gration, 2009b).
The strength of the evidence that unemployment is detrimental to mental health, would seem to imply that being in paid employment must be associated with benefits to mental health. This is true at least relative to unemployment as the literature reviewed thus far demonstrates. However the picture is not so simple; it is by no means inevitable that the absence of the detriment of unemployment constitutes a benefit. Work that is marginal (low-paid, part-time, low status or servile, low-skill, temporary, seasonal, or otherwise insecure) may be most accessible to the unemployed. This kind of environment may offer only partial or negligible well-being benefits over unemployment (Friedland & Price, 2003; Broom et al., 2006; Llena-Nozal, 2009). Neither is it safe to see reemployment as an end to a job loss episode:
“For individuals with less marketable skills or in labour markets subject to disruption through economic or technological change, unemployment can be a recurrent rather than a one time experience. In examining the impact of enforced joblessness on people’s happiness, it is thus necessary to think in terms of cumulative processes over time. Repeated periods of unemployment
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can reduce a person’s overall income, impair future employability, and lead him or her into jobs that are insecure, low-skilled and poorly paid.” (Warr, 2007:77).
Thus marginal employment may lead to further periods of unemployment, contributing to detriments to self-esteem and well-being over a longer time period, producing biographies distinct from those in stable work. In the UK and USA policies to promote labour market flexibility have led to a relative increase in work of this kind, and there is mounting evidence of health effects of job insecurity (Bartley, Ferrie & Montgomery, 2006). Some have characterised this growing disadvantaged group as ‘the precariat’ (e.g. Bambra, 2011; Standing, 2011). Dooley (2003) suggests that the dichotomy between employment and unemployment is inadequate and that thinking in terms of continuum of employment status may be more useful.12
Evidence relating to the hidden economy is scarce, but Šverko et al. (2008) suggest that illegal working may offer some of the latent benefits of legal employment. However this might be mitigated by anxiety associated with its insecurity, and an increased risk of all kinds of occupational health threats including psycho-social hazards (WHO, 2007).
A useful synthesis of the literature on work and mental health is provided by Dodu’s (2005) broad but balanced literature review, which finds that the relationship between work and well-being is a complex one.
“Being without employment is not always bad for our well-being but keeping active and having purposeful activities is good for our well-being…So the answer to the question ‘is work good for well-being?’, for the moment is ‘It depends’. All we seem to be able to say for sure is that it is dependent on the individual and the situation. ” (Dodu, 2009: 28-9).
12
Part-time work is not necessarily of poor quality. Willson & Dickerson (2010) found positive effects of part-time employment for working mothers in the UK for life satisfaction and mental well-being, but only in higher skilled occupational groups; most part-time work was in low skilled occupations. This suggests interactions between gender, occupational status, work quality, hours worked and well-being. Availability of childcare is another factor they identify as influencing the ‘trade off’ made between job quality and work intensity by women in their sample.
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A bolder position is taken by Waddell & Burton (2006), who provided an authoritative review of the published literature reviews for the Department for Work and Pensions (DWP). Still there are caveats:
“There is a strong evidence base showing that work is generally good for physical and mental health and well-being. Worklessness is associated with poorer physical and mental health and well-being. Work can be therapeutic and can reverse the adverse health effects of unemployment. That is true for
healthy people of working age, for many disabled people, for most people with common health problems and for social security beneficiaries. The provisos are that account must be taken of the nature and quality of the work and its social context; jobs should be safe and accommodating. Overall, the beneficial effects of work outweigh the risks of work, and are greater than the harmful effects of long-term unemployment or prolonged sickness absence. Work is generally good for health and well-being.” (Waddell & Burton, 2006: ix; their bold typeface).
The preceding discussion would seem to point to unemployment as a status which tends to deprive people of access to psycho-social factors that promote well-being; conversely work may provide them, but the extent to which it succeeds or fails to do so is contingent upon local situational and individual factors interacting in complex ways.
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