title: Hopelessness, demoralization and suicidal behaviour: the backdrop to welfare reform in Australia.
abstract: OBJECTIVE
  To estimate rates of suicidal ideation and attempts, and psychological characteristics of demoralization among Australian income support recipients. To provide information for policy-makers to inform the current welfare reform discussion.
  
  
  METHODS
  Data from the 1997 National Survey of Mental Health and Wellbeing were analysed using sequential logistic regression models, comparing working age people dependent on government income support payments with those having other main sources of income.
  
  
  RESULTS
  Three groups of income support recipients, unemployed, lone mothers and disability payment recipients, reported significantly higher levels on all psychological measures related to demoralization (hopelessness, worthlessness and dissatisfaction with life) than non-recipients. A similar pattern was demonstrated for measures of suicidal ideation and reported suicide attempts, with increased odds of between 3 and 9 for these high-risk groups of welfare recipients. The elevated rates of suicidal ideation, attempts and demoralization among income support recipients were in part explained by sociodemographic characteristics (socioeconomic status, age, educational qualification, experience of serious violence, loneliness, experience of psychiatric disorders), though the unemployed and disability payment recipients remained elevated on the psychological measures.
  
  
  CONCLUSIONS
  Demoralization, poor mental health and suicidal behaviour are common among income support recipients targeted by recently announced welfare reforms. This needs to be considered in the design and implementation of Australian Government policies. Psychiatric epidemiology has a key role in policy development and evaluation.
authors.affiliation: Centre for Mental Health Research, The Australian National University, Canberra, Australian Capital Territory 0200, Australia. peter.butterworth@anu.edu.au
authors.forename: Peter
authors.initials: P
authors.lastname: Butterworth
authors.forename: A Kate
authors.initials: AK
authors.lastname: Fairweather
authors.forename: Kaarin J
authors.initials: KJ
authors.lastname: Anstey
authors.forename: Timothy D
authors.initials: TD
authors.lastname: Windsor
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D004185:Disability Evaluation; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D007406:Interview, Psychological; D008132:Loneliness / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009013:Morale; D009042:Motivation; D019989:Persons with Intellectual Disabilities / Q000523:psychology; D011640:Public Policy; D012307:Risk Factors; D012649:Self Concept; D015406:Single Parent / Q000523:psychology; D012943:Social Security; D012946:Social Welfare / Q000523:psychology*; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D013405:Suicide / Q000523:psychology* / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data; D014478:Unemployment / Q000523:psychology; D014754:Violence / Q000523:psychology