Psychological Medicine

Original Articles

Common mental disorders, unemployment and psychosocial job quality: is a poor job better than no job at all?

P. Butterwortha1 c1, L. S. Leacha1, S. McManusa2 and S. A. Stansfelda3

a1 Psychiatric Epidemiology and Social Issues Unit, Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia

a2 National Centre for Social Research, London, UK

a3 Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, London, UK


Background Employment is associated with health benefits over unemployment, but the psychosocial characteristics of work also influence health. There has, however, been little research contrasting the prevalence of psychiatric disorders among people who are unemployed with those in jobs of differing psychosocial quality.

Method Analysis of data from the English Adult Psychiatric Morbidity Survey (APMS) considered the prevalence of common mental disorders (CMDs) among 2603 respondents aged between 21 and 54 years who were either (i) employed or (ii) unemployed and looking for work at the time of interview in 2007. Quality of work was assessed by the number of adverse psychosocial job conditions reported (low control, high demands, insecurity and low job esteem).

Results The prevalence of CMDs was similar for those respondents who were unemployed and those in the poorest quality jobs. This pattern remained after controlling for relevant demographic and socio-economic covariates.

Conclusions Although employment is thought to promote mental health and well-being, work of poor psychosocial quality is not associated with any better mental health than unemployment. Policy efforts to improve community mental health should consider psychosocial job quality in conjunction with efforts to increase employment rates.

(Received April 12 2012)

(Revised October 02 2012)

(Accepted October 09 2012)

(Online publication November 22 2012)

Key words

  • Employment;
  • mental health;
  • psychosocial;
  • unemployment


c1 Address for correspondence: P. Butterworth, Associate Professor, Psychiatric Epidemiology and Social Issues Unit, Centre for Research on Ageing, Health and Wellbeing, Building 63 Eggleston Road, The Australian National University, Canberra, ACT 0200, Australia. (Email: