title: Within-person analysis of welfare transitions in a longitudinal panel survey reveals change in mental health service use.
abstract: While international research shows that receipt of welfare benefits is associated with poor mental health, less is known about the relationship between welfare receipt and mental health service use. We investigate whether within-person change in welfare recipient status is associated with change in mental health service use.
  
  
  
  Analysis of two waves of data from an Australian national household survey. Random- and fixed-effect models considered the effect of change in welfare receipt status, and assessed whether change in mental health service use differed by type of welfare benefit or the direction of welfare transition.
  
  
  
  Individuals were more likely to report greater mental health service use at times of welfare receipt. These associations were attenuated, but remained significant, after adjusting for mental health. Increased health service use was not tied to specific types of welfare benefits. The increase in mental health service use associated with a transition onto welfare benefits was much greater than the decline in service use associated with the transition off benefits.
  
  
  
  Within individuals, welfare receipt is associated with greater mental health service use. While this does reflect poorer mental health at the time of welfare receipt, other factors seem to facilitate health service use.
authors.affiliation: Psychiatric Epidemiology and Social Issues Unit, Centre for Research on Ageing, Health & Wellbeing, Research School of Population Health, Australian National University, Canberra ACT 0200, Australia.|Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville VIC 3010, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Pymont
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville VIC 3010, Australia.
authors.forename: T P
authors.initials: TP
authors.lastname: Schofield
authors.affiliation: Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Parkville VIC 3010, Australia.|Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, Parkville VIC 3010, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Butterworth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012946:Social Welfare / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: health service research; longitudinal; mental health; social inequalities; unemployment