Development and Mental Health

Paper Session

Saturday, Jan. 7, 2017 2:30 PM – 4:30 PM

Swissotel Chicago, Zurich A
Hosted By: American Economic Association
  • Chair: Johannes Haushofer, Princeton University

Depression for Economists

Jonathan de Quidt
,
IIES Stockholmn University
Johannes Haushofer
,
Princeton University

Abstract

Major depressive disorder (MDD) is one of the most prevalent mental illnesses worldwide. Existing evidence suggests that it has both economic causes and consequences, such as unemployment. However, depression has not received significant attention in the economics literature. In this paper, we present a simple model which predicts the core symptoms of depression from economic primitives, i.e. beliefs. Specifically, we show that when exogenous shocks cause an agent to have pessimistic beliefs about the returns to her effort, this agent will exhibit depressive symptoms such undereating or overeating, insomnia or hypersomnia, and a decrease in labor supply. When these effects are strong enough, they can generate a poverty trap. We present descriptive evidence that illustrates the predicted relationships.

Can Cash Transfers Prevent Suicides? Experimental Evidence From Indonesia

Cornelius Christian
,
St. Francis Xavier University
Christopher Roth
,
University of Oxford

Abstract

We examine how income shocks affect mental health, using novel village-level census data on Indonesian suicides, and two identification strategies. First, we exploit a randomized experiment on cash transfers, and second, we use the population-wide roll-out of the same cash transfer program. We find evidence from both identification methods that the cash transfer program decreases the probability of suicide by about 15 percent within a sub-district. The effects are driven by sub-districts that have been in receipt of the cash transfer program for a longer period of time, i.e. medium term effects seem to be stronger than short-term effects. Our evidence supports the view that economic circumstances are an important motive for suicides, and that social welfare programs can effectively improve mental health among the ultra-poor in developing countries.

Does mental health affect women's financial empowerment? Experimental evidence from an RCT treating maternal depression

Victoria Baranov
,
University of Melbourne
Sonia Bhalotra
,
University of Essex
Joanna Maselko
,
Duke University

Abstract

We evaluate the long-term impact of treating depression on women's financial empowerment by exploiting experimental variation induced by a Randomized Control Trial which provided psychotherapy to perinatally depressed mothers in rural Pakistan. The intervention provided Cognitive Behavioral Therapy (CBT) for nearly 1 year postpartum and was highly successful, reducing depression rates by 31 percentage points in the treated group relative to control after 1 year. To evaluate the long-run effect, we successfully re-located 83% of the the original sample 7 years later. We find that the mental health benefits persist even 6 years after the intervention concluded: treated mothers were 6 percentage points less likely to be depressed and had higher mental health scores of 0.2 standard deviations. The intervention was especially effective, both in the short-and long-run, for mothers who were identified as vulnerable based on low social support at baseline. In the long-run, the beneficial effect of CBT appears to be concentrated among mothers who did not have a grandmother of the children living with them or who had low levels of social support at baseline. This suggests that social support provides a buffer effect that enables recovery, for which treatment is a substitute. Finally, we find evidence that the intervention improved mother's empowerment in the short-run and increased her financial autonomy- her labor supply, income, and ability to make spending decisions- in the long run. The long-run effects on mother's financial autonomy appear to be driven by the vulnerable subgroup of women who benefited most from the intervention.

Fetal Origins of Mental Health: Evidence From Africa

Achyuta Adhvaryu
,
University of Michigan
James Fenske
,
University of Oxford
Namrata Kala
,
Yale University
Anant Nyshadham
,
University of Southern California

Abstract

Mental health disorders are a substantial portion of the global disease burden, yet their determinants are understudied, particularly in developing countries. We find that temperature shocks in utero increase depressive symptoms in adulthood in Africa. A ten percent increase in heat exposure increases our depression indices .05 to .07 standard deviations. We find no evidence that the effects of these shocks are smaller for more recent birth cohorts, nor do shocks predict greater treatment of depressive symptoms. Temperature fluctuations, increasingly frequent due to climate change, worsen the mental health disease burden and health care systems in Africa do not mitigate these impacts.
Discussant(s)
Justin Wolfers
,
University of Michigan
Achyuta Adhvaryu
,
University of Michigan
Berk Özler
,
World Bank
Sarah Baird
,
George Washington University
JEL Classifications
  • I3 - Welfare, Well-Being, and Poverty
  • O1 - Economic Development