Patterns of Psychiatric Hospitalization Among Different Socioeconomic Groups in Response to Economic Stress

Economic change appears to have a substantial impact on the mental hospitalization of various socioeconomic groups. This relationship is not confined to the admissions of relatively low or relatively high socio-economic groups. In other words, it is not necessarily the traditional “poor” who become psychiatric victims of precipitating economic stress. It is likely that under sufficient economic pressure, members of any socio-economic stratum will respond in terms of mental hospitalization. Members of the most economically insecure groups appear to show the greatest risk of mental hospitalization during periods of economic adversity (“downturn”) for the general population. This generalization is supported by the findings of independent economic studies. A comparison of these findings with those of the present study shows that groups which experience the greatest economic loss during the economic downturn may respond most sharply with mental hospitalization. Thus, the overall risk of mental hospitalization will be determined, in part, by: (1) social position, including education, occupation, income, sex and age, and (2) the particular patterns of ongoing social change, especially economic change. This relationship between aggregate (i.e., for the general population) short term economic change and mental hospital admissions probably grossly underestimates the overall effects of economic stress on the mental hospitalization of individuals. In the first place, short term fluctuations in aggregate economic activity represent only one major type of aggregate economic change. It excludes long term technological and social-economic changes which will vary, for example, by industry, occupation, region and the demographic composition of the labor force. Secondly, these short term aggregate economic fluctuations are measured by short term variations in the manufacturing employment index. This measure is at best an extremely crude estimate of changes in the average economic behavior of persons in all industries, occupations, regions and firms within the area under study (New York State). Thirdly, and most important, the greatest proportion of economic change in the lives of individuals does not stem from aggregate changes in the economy as a whole. The most frequent economic changes are results of career patterns, retirement, physical and mental illness, death, marriage, care and education of the young, and separation and divorce.