People without jobs or with less secure housing have poorer outcomes when treated for depression with talking therapy or antidepressants, compared to more socially advantaged peers, according to UCL led research.
The authors of the study, published in JAMA Psychiatry, said that addressing employment and housing needs may be helpful alongside depression treatments to support the mental health of people who are socioeconomically disadvantaged.
The researchers combined evidence from nine studies, which included a total of 4,864 people who had been treated for depression, where data was available on socioeconomic factors such as jobs and housing.
They found that after three to four months of treatment, unemployed patients had 28% worse depression symptoms than those who were employed. Homeowners’ depression symptoms were 18% better than for people who were homeless or living in hostels or with family and friends.
Lead author Dr Joshua Buckman (UCL Psychology & Language Sciences and Camden & Islington NHS Foundation Trust) said: “We found that people who are unemployed or live in less secure housing have a poorer outcome when treated for depression. Additional support to access employment or housing could also lead to improvement in mental health.
“From our findings, we cannot confirm whether helping to improve people’s work and housing situations would improve their mental health directly, or if it would set them up to be more able to engage in treatment. For example, it might make it easier to turn up to all of their appointments if they can stay in the same accommodation regularly without having to move out of the area.
“We hope that further research will shed more light on how best to support the mental health needs of people experiencing social disadvantage.”
Senior co-author Professor Stephen Pilling (UCL Psychology & Language Sciences) said: “Clinicians can easily ask their patients about housing status and employment, and our findings suggest that this should then inform their treatment plans. If possible, a referral for support in finding secure housing or employment may be beneficial, or else by knowing that such patients are less likely to get better, clinicians might consider a more intensive treatment or additionally prioritise a follow-up appointment soon after starting treatment to see if it is having the desired effect.”
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