The impact of unemployment on mental health examined in a community mental health unit during the recent financial crisis in Greece.

Financial crisis has significant impact on the mental health of the population, resulting in increasing incidence of mental disorders and suicides. Specific social and financial factors mediate the effects of financial crisis on mental health, such as poverty, financial difficulties and unemployment. During the recent international financial crisis, studies in many countries have shown that the worsening of various mental health indicators was related to financial difficulties and unemployment. In Greece, which is one of the countries that experienced intense and prolonged economic and social burden due to the recent crisis, the epidemiological findings were similar and the increase of the prevalence of major depression and suicide was excessive. However, the information about the mental health of the population deriving from health services is limited. The aim of this study was to investigate the impact of the crisis on community mental health -more specifically the rates of mental disorders and suicide, as well as the role of unemployment- among the new cases of a community mental health unit. The sample consisted of 1,865 adult users, men and women, who came seeking for help to the Byron-Kessariani Community Mental Health Centre (CMHC) during the years 2008-2013, i.e. the early years of the current crisis. Regarding the rates of the diagnostic categories in the new cases of CMHC per year, no significant differentiation was observed. There was an increase in the proportion of the unemployed individuals in the total sample of new cases during the study, from 9.65% in 2008 to 26.17% in 2013 and a significant association between unemployment and the occurrence of anxiety and depressive disorders, as indicated by the increase in the proportion of unemployed individuals among new cases with disorders of these categories. There was an upward trend in the rate of new patients referred to CMHC after a suicide attempt, which was doubled during the first years of the crisis. There was also an increase in the rate of unemployed individuals among these cases, from 10% in 2008 to 41.7% in 2009, reaching the highest level in 2011 (53.3%). The findings of this study suggest that during economic crisis unemployment plays an important role in the development of anxiety and depressive disorders and is closely related to suicide attempts. Our results were derived from a specific catchment area and therefore they have high ecological validity.