The economic downtown that began in 2008 has been hardest on the mental health of men in England - yet it isn't the actual unemployment and falling household income the authors blame. They blame the threat of losing their jobs in a society that places an unrealistic level of pressure on males to be the breadwinners.

They base their findings on data taken from the national representative annual Health Survey for England for adults aged 25 to 64, between 1991 and 2010.  Response rates during the period varied from 85 per cent in 1991 to 64 per cent in 2008, and included almost 107,000 people.

Respondents were asked about their employment status and educational attainment, and those scoring 4 or more on the General Health Questionnaire-12, which is used to gauge levels of anxiety and depression, were deemed to have a high likelihood of poor mental health. The analysis showed that rates of poor mental health were highest between 1991 and 1993, when the UK was in recession, after which they fell steadily until 2004, when they started a gradual rise until 2008, at which point they rose sharply. In 2008, when the global economic downturn began, the prevalence of mental ill health was 13.7 per cent, rising to 16.4 per cent in 2009, falling back to 15.5 per cent in 2010.

At other times, more women than men reported poor mental health but during periods of recession the sharpest rises in the prevalence of mental ill health occurred among men. In the early 1990s, the prevalence of mental ill health among men rose from 12.3 per cent in 1991 to 14.5 per cent in 1992. A similar trend occurred in the 2008 economic downturn when the prevalence among men rose from 11.3 to 16.6 per cent among men in 2009; among women this rose from 16 to 16.2 per cent.

Factoring in age, indicated that the prevalence of poor mental health among men increased by 5.1 per cent in 2009 and by 3 per cent in 2010. There were no such significant increases among women. But the study only examined changes in mental health up to 2010, and women may have been affected more severely after this time, particularly given subsequent changes in public sector employment, say the authors. The prevalence of mental ill health, however, was not confined to those out of work; and taking account of employment status and educational attainment made no difference to the figures.

"The finding that mental health across the general population has deteriorated following the recession's onset, and that this association does not appear to be limited to those out of employment nor those whose household income has declined, has important implications," say the authors.

They suggest that the reason for the gender differences in the impact of recession could be that men's mental health is more vulnerable to the fear of job loss.

"One potential explanation for our results would be that job insecurity during the current recession is responsible for the deterioration in mental health, with men's psychological health remaining more affected by economic fluctuations despite greater female labour market participation," they conclude.

Citation: Srinivasa Vittal Katikireddi, Claire L Niedzwiedz, Frank Popham, 'Trends in population mental health before and after the 2008 recession: a repeat cross-sectional analysis of the 1991–2010 Health Surveys of England', BMJ Open 2012;2:e001790 doi:10.1136/bmjopen-2012-001790 (Open Access)