LIVING WITH UNEMPLOYMENT AND UNDEREMPLOYMENT: POOR, ISOLATED AND STRUGGLING TO CHANGE Laura Crowe A thesis submitted for the degree of Doctor of Psychology (Clinical) The Australian National University. May 2016 Research School of Psychology College of Medicine, Biology and the Environment The Australian National University Canberra, ACT, Australia Declaration This thesis is submitted to The Australian National University in fulfilment of the Doctor of Psychology - Clinical (DPsych) degree. The work presented in this thesis is, to the best of my knowledge, original except as acknowledged in the text. I hereby declare that I have not submitted this material, either in full or in part, for another degree at this or any other institution. This thesis includes two papers that are in press with peer reviewed journals. The third paper is under preparation for submission. The ideas, development and writing up of both the papers in the thesis were the principal responsibility of me, the candidate. The inclusion of a co-author reflects the input of my supervisor, Associate Professor Peter Butterworth and my advisor Liana Leach who provided advice on the design and assisted with proof reading and editing. In the case of chapters 5, 6 and 7 my contribution to the work involved the following: Chapter Publication Title Publication Nature and extent of candidate’s Status contribution 5 The role of financial hardship, In press (2016) – Conceptual development, design, mastery and social support in the BMJ Open data analyses and principal author association between employment status and depression: Results from a longitudinal cohort study Authors: Laura Crowe and Peter Butterworth 6 Mental health and inadequate In press – Social Conceptual development, design, employment in Australia: analysis Science and data analyses and principal author of data from the HILDA Survey. Medicine: Population Authors: Laura Crowe, Peter Health Butterworth and Liana Leach 7 Job seeking in the face of Under Conceptual development, design, unemployment: depression, preparation for participant recruitment, mastery, social support, and submission administration, data analyses and financial hardship principal author Authors: Laura Crowe, Peter Butterworth and Liana Leach ____________________ ____________________ ____________________ Laura Crowe Peter Butterworth Date 3 Acknowledgements First and foremost, I would like to express my very sincere appreciation to my research supervisor Associate Professor Peter Butterworth, who was always there to offer guidance, encouragement, and feedback – which was always delivered with good humour, understanding, and provided me with great learning and development. His enthusiasm and commitment in assisting me with this project was invaluable. I also wish to express my appreciation to Dr Liana Leach for her support and optimism. Her constructive and thoughtful feedback was instrumental in getting me to the finish line in these final throes. I’d also like to thank Dr Richard O’Kearney for providing his clinical expertise and perspective. Thank you to those who took the time to participate in my research. Your participation provided me with treasured insight into your lives and experiences. I am hugely grateful for your time and effort. I would also like to acknowledge the practical assistance provided by the Psychology Department administrative task throughout these past years. Finally, I’d like to thank my friends and family who have encouraged and supported getting me to this point. And to my lovely, generous friend Jen, who painstakingly copy edited my document. Thank you for ignoring my protests, and doing it anyway. In particular, I’d like to thank my parents, who (unfalteringly) provided me with sustenance, positive morale and support throughout this whole process, and if not for you both, I definitely could not have completed this task. 4 Abstract The experience of unemployment or underemployment can cause substantial psychological and social impairment in the lives of those who are unable to find good quality work. People who suffer from mental health problems are over-represented amongst the unemployed when compared to those who are gainfully employed. The overarching goal of this project was to investigate the mechanisms through which unemployment and underemployment may impact mental health. Three factors that have emerged as important predictors of poor mental health in the unemployed are financial hardship, social support and a sense of control/mastery. This thesis presents three studies centred on the links between mental health and employment status, and explores the role of mastery, financial hardship, and social support. The first study used longitudinal data from a community sample from the Canberra/Queanbeyan region. Two thousand, three hundred and eighty-nine participants initially aged in their early twenties were followed across eight years and three waves. Social support, financial hardship and mastery all emerged as important mediating variables in the relationship between unemployment and depression, compared to the employed. These results suggest that these factors are indeed salient characteristics in the experience of unemployment. By contrast, for the underemployed group, only financial hardship demonstrated a mediating effect on the association between underemployment and depression – suggesting that even inadequate employment may provide a greater source of mastery and social support than no work at all. The second study also used longitudinal data to build upon these findings by using a nationally representative sample from three waves, as well as exploring the impact of duration of unemployment on mental health. The results broadly supported the findings of Study 1 regarding unemployment, though the findings differed regarding underemployment. Financial hardship, mastery and social support all emerged as important explanatory factors for poor mental health differences (compared to the employed) for both under- and unemployment states. In regards to the impact of time spent unemployed on mental health, comparison of respondents with different durations of unemployment suggested that for the first 9 weeks of unemployment there is a strong negative association between mental health 5 and duration of unemployment. However, after these first nine weeks mental health does not continue to decline. This is a particularly salient finding given recent Australian Government policy changes that have proposed a ‘wait-time’ before individuals can claim welfare assistance after losing a job. The final study investigated whether mastery, social support and financial hardship was related to high depressive symptomatology within a sample of unemployed and under- employed individuals (n = 192). Furthermore, it explored how these factors may influence key factors related to reemployment, or indeed continued unemployment: job search intensity, job search expectations and intentions. The results indicated that differences in depression were related to financial hardship, mastery and some measures of social support, as were those in the first seven weeks of unemployment. These correlates of depression were also shown to be associated with job seeker’s job search intensity, expectations and intentions – suggesting that the factors associated with poor mental health also play a role in job search outcomes. The results of these studies have three main implications. First, financial hardship, social support and a sense of mastery help to explain differences seen in the mental health between employment states (unemployed v. employed, underemployed v. employed), as well as being important correlates of depression amongst the unemployed and underemployed. Second, the impact of financial hardship, social support and a sense of mastery on the job search process may hinder or enhance chances of reemployment. Finally, future research needs to more comprehensively consider the duration of unemployment when investigating the impact of unemployment on mental health, as the results suggest that there is not a linear relationship. There are also important implications from these findings for the types of psychological and other support that is most applicable for those who are unemployed. 6 Table of Contents Declaration 3 Acknowledgements 4 Abstract 5 CHAPTER ONE 10 1.1 Thesis Topic 10 1.2 General Aims 11 1.3 Aims of Specific Chapters 12 1.4 The Importance of this Thesis and Contribution 16 CHAPTER TWO 19 2.1 Summary 19 2.2 Background: Unemployment and Underemployment in Australia 19 2.3 The Psychological Impact of Unemployment and Underemployment 22 2.4 Understanding the Relationship between Unemployment and Mental Health: Theoretical Perspectives 29 CHAPTER THREE 39 3.1 The Psychological Impact of Unemployment/Underemployment: Mastery, Financial Hardship and Social Support 39 3.2 The Psychological Impact of Unemployment and Underemployment: Duration of Unemployment/Job Seeking 44 3.3 Unemployment, Mental Health and the Job Search Process: Barriers to Reemployment 45 3.4 The Psychological Impact of Unemployment and Underemployment: Covariates 49 3.5 Project Aims 56 CHAPTER FOUR 58 4.1 Summary 58 4.2 PATH – Community Level Dataset 58 4.3 HILDA – Nationally Representative Dataset 59 7 4.4 Statistical analysis – Multivariable Logistic Regression Modelling and Mediation 60 CHAPTER FIVE 63 Study 1 63 CHAPTER SIX 87 Study 2 87 CHAPTER SEVEN 119 Study 3 119 CHAPTER EIGHT 149 8.1 General Findings 149 8.2 Implications for Practitioners, Policy and Individuals 156 8.3 Limitations 159 8.4 Future Research 160 8.5 Conclusions 161 APPENDICES 180 Appendix A: Study 2 Supplementary Materials 181 Appendix B: Study 3 Information Sheet 186 Appendix C: Study 3 Questionnaire 188 Appendix D: Study 3 Debrief Sheet 197 Appendix E: Study 3 Poster 199 8 Table of Figures Figure 1.1 Overview of PATH Through Life Study Design (20s Cohort only) ............. 59 Figure 1.2 Mediation Model: Employment status and mental health ............................. 61 Figure 6.1. Non-parametric regression between duration of unemployment and mental health (graph) ................................................................................................................ 118 Figure 7.1 Non-parametric regression graphs between duration of job seeking and depression/mastery/financial hardship/social support (family)…... ………………..133 Figure 7.2 Non-parametric regression graphs between duration of job seeking and job search components: Job search intensity, job search expectation and job search intention ....................................................................................................................................... 133 Figure 8.1 Problem-focused coping versus Emotion-focused coping .......................... 158 Table of Tables Table 2 1. Summary of meta-analyses and systematic reviews (Murphy & Athanasou, 1999; McKee-Ryan et al., 2005; Paul & Moser, 2009) .................................................. 25 Table 5. 1. Descriptive statistics reporting health, socio-economic, demographic and psychosocial characteristics of respondents across the three waves. .............................. 72 Table 5. 2. Prevalence of depression and univariate relationship between depression and various socio-economic, demographic and psychological measures. ............................. 73 Table 5. 3. Results of a multivariable logistic regression analyses for predictors of depression ........................................................................................................................ 76 Table 5. 4. Percentage of difference between unemployed (and PTLFT) and employed persons in the prevalence of depression .......................................................................... 77 Table 6.1. Sample Characteristics (N = 9382), by age and gender. .............................. 100 Table 6.2. Univariate associations between low scores on the MHI-5 (SF-36) and employment status, financial hardship, low sense of mastery, and poor social support. ....................................................................................................................................... 101 Table 6.3. Odds ratios (and 95% confidence intervals) from a series of logistic regression models assessing the relationship between depression and financial hardship, mastery, and social support (bold indicates significance). ............................................ 103 Table 6. 4. Fraction of difference between unemployed and employed (as well as PTLFT and employed) persons with depression mediated by socio-demographic, financial hardship, a sense of mastery, and social support measures............................ 105 Table 6.5. Regression analyses assessing the relationship of mental health measure and duration of unemployment (first 9 weeks of unemployment, compared to 9 – 52 weeks of unemployment) ......................................................................................................... 106 Table 7.1 Descriptive statistics reporting health, socio-economic, demographic and psychosocial characteristics of respondents across four age groups. ............................ 130 Table 7.2 Univariate and multivariate relationships between depression and various socio-economic, demographic and psychological measures. ........................................ 131 Table 7.3 Regression analyses assessing the relationship of mental health measure and duration of unemployment (first 9 weeks of unemployment, compared to 9 – 52 weeks of unemployment) ............................................................................................................. 132 Table 7.4 Job search Intensity: Univariate and Multivariate Regression ..................... 136 Table 7.5 Job Search Expectation: Univariate and Multivariate Regression ................ 137 Table 7.6 Job Search Intention: Univariate and Multivariate Regression .................... 138 9 Chapter One Thesis Overview: Exploring the mental health of the underemployed and unemployed 1.1 Thesis Topic Employment not only provides economic and financial stability, but is a central mechanism for social inclusion and mental wellbeing. The unemployment literature also demonstrates the harmful effects of unemployment on psychological wellbeing (for review see Murphy & Athanasou, 1999; Paul & Moser, 2009). Unemployment, or inadequate employment, is often viewed by economists as an economic problem rather than a psychological one (Dollard & Winefield, 2002). Yet, a report prepared by Access Economics (2009) found that the financial cost of mental illness in young people in Australia was $10.6 billion. Seventy percent of this cost was accounted for by productivity lost due to lower employment, absenteeism and premature death of young people with mental illness (Access Economics, 2009). So, while unemployment is often considered an economic topic, the psychological consequences are considerable. As people must work to obtain wages as a major source of their income, not having a job means lower income and poorer access to social resources (Randall, 2009). Furthermore, particularly for young adults, working is vital for establishing independence and a sense of personal identity (Winefield, Tiggemann, Winefield, & Goldney, 1993). Even a short period of unemployment can precipitate a series of events that can affect a broad range of outcomes far into the future – from health status to future income earnings, blood pressure, and even low birthweight of children (Adler & Newman, 2002). Therefore, as low unemployment also reduces poverty and inequality, it is not surprising that both economic and social policies seek to achieve greater workforce participation. 10