The University of Cincinnati found that depression treatment is more likely to work for patients who are employed, or have a degree
Scientists at the University of Cincinnati looked at how 665 patients responded to 12 weeks of antidepressant medication treatment.
Previous research has linked lower income and less education to worse outcomes for mental health treatment. In the Global South, it is estimated that 80-90% of people living with depression lack a diagnosis or access to treatment. In Canada, older women were found to suffer more from loneliness and depression if they lived in care facilities during COVID lockdowns.
But scientists say it can be difficult to untangle intertwined socioeconomic factors.
Non-white patients improved 11.3% less than their counterparts, after same treatment
The team found that patients who were non-white improved 11.3% less than white patients, while unemployed individuals had a 6.6% less improvement in comparison to employed patients. These differences existed outside of gender and age differences, with the exact same type of depression treatment.
The scientists also found that patients without a University degree had 9.6% less improvement than graduates.
Professor Jeffrey Strawn, in the Department of Psychiatry and Behavioral Neuroscience in UC’s College of Medicine, said: “We think about these things in terms of access, we think about them in terms of income inequality, and I realize that education does track with those, but just having a college degree while controlling for all of these other factors still had a significant impact.”
Socioeconomic considerations can improve depression treatment outcomes
According to the scientists who analysed this data, this insight can remove barriers of access to treatment. Professor Strawn says that doctors need to acknowledge that a patient’s socioeconomic environment can actually shape if they get better or not. This would be an important thing to understand when creating future treatment plans and measuring current progress.
Resource-poor environments are also affected by more chronic variable stress, which just means high stress in a pattern that is intermittent and difficult to predict. Separate studies confirm that the experience of unpredictable stress can trigger depression, ruling out short term stressors like exam revision.
“So this is, ‘I was able to pay my rent this month, but I’m not sure that I will be able to next month. And I have a job right now, but I don’t know that I will next month,’” Strawn said.
“So it’s just the impact of all those things as well as maybe having relatives or kids who have fewer educational resources or other job-related stress, or potentially other health problems, and you’re still running into those same barriers in terms of access and cost and support there.”
In a larger picture approach, this research has significant implications for economic policy. For instance, the impact of a minimum wage policy can directly shape depression outcomes – but mental health is usually never considered as a direct impact of policy-makers.
