Cash transfers and the mental health of young people: Evidence from South Africa's child support grant

E.C Garman,K Eyal,M Avendano,S Evans-Lacko,C Lund

doi:10.1016/j.socscimed.2021.114631

Abstract

This study examines the longitudinal impact of the South African Child Support Grant (CSG) on risk for depression and life satisfaction among young people (15–19 years). We analysed data from the last three waves of the National Income Dynamics Study (NIDS), a nationally representative panel survey that took place every two years from 2008 to 2017. We used an instrumental variable (IV) approach that exploits multiple changes in age eligibility from 1998 to 2012. Depressive symptoms were assessed using an 8-item version of the Centre for Epidemiological Studies Depression Scale; participants who scored above 8 were considered at risk for depression. Life satisfaction was rated on a scale of 1 (‘very dissatisfied’) to 10 (‘very satisfied’); participants who scored 8 or above were classified as satisfied. We also examined impacts on educational deficit (≥2 years behind) and not being in education, employment or training (NEET) as secondary outcomes, as these are also important for mental health. Age eligibility strongly predicted CSG receipt at Wave 3. In instrumental variable models, CSG receipt did not influence the risk for depression (β = 0.10, SE = 0.10, p = 0.316), nor life satisfaction (β = −0.07, SE = 0.09, p = 0.420) at Wave 3, nor at Waves 4 or 5. Some improvements in educational deficit were observed at Wave 3 among CSG beneficiaries compared to non-beneficiaries. These results were robust to multiple specifications. CSG receipt did not improve the psychological wellbeing of adolescents and young adults, nor did it improve their education or employment outcomes. Our findings highlight the need to identify alternative social policies that address the root causes of youth social disadvantage, in conjunction with targeted approaches to improve the mental health of young South Africans living in poverty.

Highlights

Common mental disorders such as depression often emerge in adolescence or early adulthood (Whiteford et al, 2013), at a time when young people face major physical, social and psychological changes
Using a nationally representative sample of young South Africans, we find no effect of Child Support Grant (CSG) on the risk of depression or life satisfaction among adolescents and young adults, either in the short or longer term
Our findings corroborate those of Kilburn et al (2016)’s study among 13–20-year-old South African girls, indicating that a conditional cash transfer did not have an effect on depressive symptoms

Summary

Introduction

Common mental disorders such as depression often emerge in adolescence or early adulthood (Whiteford et al, 2013), at a time when young people face major physical, social and psychological changes. Cash transfers have become a dominant poverty reduction policy across many LMICs. Cash transfers have become a dominant poverty reduction policy across many LMICs While these programmes offer immediate poverty relief, evidence suggests that they improve education, employment and overall life chances, and through this mechanism they may improve the mental health of children and young adults (see theoretical framework in Appendix 1). In a meta-analysis on primary and secondary school children in LMICs, Garcia and Saavedra (2017) found that conditional cash transfers improved school enrolment, attendance, dropout and completion, the effect depended largely on programme characteristics. A recent review indicates that evidence that these programmes can improve the mental health of young people in LMICs is inconclusive (Zimmerman et al, 2021). An earlier meta-analysis by Pega et al (2017) found no evidence that uncondi tional cash transfers reduce depression among children or adults

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