Impact of the Great Recession on mental health, substance use and violence in families with children: A systematic review of the evidence

Abstract

ObjectivesThis review summarises the existing evidence on the effects of the Great Recession on mental health, substance use and violence in families with children and discusses the policy and service-system implications of this evidence. MethodsPeer-reviewed articles published in English between January 2010 and August 2020 were identified through a systematic search of the main scientific databases, citation records, and manual searches of individual journal sites. Studies focusing on children, or their parents, that included an exposure variable measuring the Great Recession and had an outcome related to mental health, substance use or violence were included. A risk of bias assessment and narrative synthesis were provided. ResultsIn total 40 studies were analysed. Most of the studies were deemed to have a moderate risk of bias (29), nine had a high risk of bias and two had a low risk of bias. High-quality studies provided evidence that the economic recession of 2008 (termed ‘the Great Recession’ in this paper) did hurt children’s mental wellbeing. The evidence regarding substance use in families with children was scarce but there were some indications that the recession increased drug and alcohol use among economically vulnerable subgroups. Studies with individual level data from the US showed that the Great Recession increased the risk of child maltreatment, but little evidence of this was found in several ecological and population level time-trend analyses. ImplicationsCounter-cyclical investments in and further integration of social, education and health services targeted not only at adults but also at families with children are crucial in alleviating human suffering in economic recessions. Subsequent research with the combination of high-quality individual and aggregated level data is warranted to assess the potential effects of recessions on substance use and violence in families with children. During the unprecedented economic changes following the COVID-19 pandemic, it is crucial to monitor timely mental health, substance use and violence in families at risk.