The financial situation of people with severe mental illness in an advanced welfare state

Summary of Working paper 2022:19

Schizophrenia spectrum, bipolar, and major depressive disorders are severe mental illnesses (SMIs) that not only entail great suffering for those affected but also major societal costs. In this study, I use administrative register data to provide a detailed picture of the economic situation of people with SMI in Sweden during a period of 10 years around first-time in-patient diagnosis. First-time in-patient diagnosis was associated with a considerable drop in earnings, which was largely compensated for by social transfers: mainly sickness and disability insurance. However, there were also large and increasing pre-diagnosis earnings gaps, relative to matched comparison groups, especially among those with schizophrenia spectrum disorders. This gap was to lesser extent compensated for by social transfers. Consequently, there was a permanent and increasing – due to lost earnings growth – income differential. Hence, findings in previous studies are confirmed: even in an advanced welfare state, people with SMI – especially those with schizophrenia – have an extremely weak position on the labour market and an equally difficult financial situation.

Keywords: Schizophrenia spectrum disorder, bipolar disorder, major depressive disorder, social insurances, labour market situation
JEL Codes: I13, I14, J14, J65