High Job Strain Increases Risk of Mental Health Challenges

High job demands, low job control, and high job strain are associated with the development of a mental health issue at age 50


A new study, led by Samuel Harvey, Associate Professor at the Black Dog Institute in Australia, investigates the association between job strain and mental health challenges. The results of the study, published in The Lancet Psychiatry, indicate that higher job strain increases one‚Äôs risk of developing a ‚Äúcommon mental disorder‚Ä̬†by age 50.

‚ÄúThe present study has highlighted the potential public health effect of addressing job strain factors in the workplace,‚ÄĚ write the authors.

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Mental health challenges are one of the biggest reasons why people are absent from work in high-income countries. Because of this, scholars and policymakers have been increasingly interested in the interaction between job characteristics and mental health.

The authors cite Karasek’s job demands-control model which suggests that high job demands and low job control (i.e., unable to make decisions about one’s work) lead to high job strain and may result in health problems. Cross-sectional and longitudinal studies have found an association between job strain and poorer mental health, providing support for Karasek’s model. However, the authors note that these studies have not been able to rule out reverse causation (e.g., being diagnosed with a mental health disorder may lead to having a less desirable job) or confounding factors (e.g., a third variable such as socioeconomic status is driving both job strain and mental health challenges).

Therefore, the authors sought to examine whether there is a causal relationship between high job demands, low job control, and high job strain with poor mental health. The researchers used data from the UK National Child Development Study, which included people born in the UK in 1958. The present study analyzed data from 6060 individuals who participated in a self-report survey at age 45 and had follow up data at age 50. In addition to measuring job strain and mental health, the researchers also assessed many possible confounding variables including marital status, education level, social position, occupational class, psychiatric history, stressful life events, and childhood intelligence.

After controlling for confounding factors, results show that high job demands, low job control, and high job strain at age 45 are significantly associated with developing a ‚Äúcommon mental disorder‚ÄĚ by age 50. The researchers estimate that ‚Äú14% of new cases of common mental disorder could have been prevented through the elimination of high job strain.‚ÄĚ

‚ÄúThe present study has analyzed life-course data to show that job demands, control, and strain have a prospective effect on risk of future onset of common mental disorder independent of lifetime psychiatric history and other potential confounding variables across the lifespan,‚ÄĚ the authors summarize.

Although previous studies identified an association between job strain and mental health challenges, this study is the first to suggest a causal link, providing stronger evidence for Karasek’s job demands-control model.

This study has significant public health implications as one survey found that 1/3 of men with poor mental health attribute it to their jobs. Another study found that a stressful job may be worse for a person’s mental health than being unemployed. Therefore, these findings may be used as an argument for companies to reduce job strain on their employees in order to decrease the likelihood that their employees experience mental health issues.



Harvey, S. B., Sellahewa, D. A., Wang, M. J., Milligan-Saville, J., Bryan, B. T., Henderson, M., … Mykletun, A. (2018). The role of job strain in understanding midlife common mental disorder: A national birth cohort study.¬†The Lancet Psychiatry. Advance online publication. http://dx.doi.org/10.1016/S2215-0366(18)30137-8 (Link)

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Shannon Peters
MIA Research News Team: Shannon Peters is a doctoral student at the University of Massachusetts Boston and has a master’s degree in mental health counseling. She is particularly interested in exploring the impacts of medicalization and pathologizing the experiences of individuals who have been affected by trauma. She is engaged in research on the effects of institutional corruption and financial conflicts of interest on research and practice.


    • Obvious ! Depends on who considers the evidence. But I agree, it may not change much in termes of public health policies, work force and the like but it has the merit of building stronger data on the matter. And, the conclusion is not only about feeling terrified. It’s about not being able to work, in the 50th decade of life, a period of great competency and often with a lot of productive years ahead. It can be very tragic, I went through it and now what it is like, first hand …

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  1. A lot of this is exacerbated by psychiatry’s promise of a quick fix.

    Joe Blow is trapped in an unhappy job with inadequate pay. Instead of figuring how to change his situation: get more training, find another job, work as a contractor–or how to cope with it better: stress management, living within his means with the envelope system–Joe asks his friend for advice. Jack tells Joe his girlfriend saw Dr. Quackenbush. The friendly neighborhood psychiatrist at the community center Mental Illnesses R Us.

    Dr. Quackenbush tells Joe his anxiety and unhappiness are due to a brain disease. Joe’s stressful lifestyle has NOTHING to do with either. Joe starts taking a new SSRI. He loses the ability to sleep. After 3 weeks without sleep Joe starts talking to people in the corridors at work. People no one else can see or hear. This gets Joe a ticket to the inpatient ward of Mental Illnesses R Us.

    Dr. Quackenbush swears up and down that the life-saving medication he gave Joe never has that effect on people unless they were evil/insane to begin with. He puts Joe on a double dose of the SSRI making him nuts along with a hefty dose of Haldol and Depakote and a benzo thrown in for good measure.

    Like Gregor Sampsa in Kafka’s tale, Joe gets out of working by becoming a vermin. Only in this fairy tale there’s an evil wizard behind the transformation of man into roach.

    Take a bow Dr. Quackenbush!

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  2. In the year 1930, John Maynard Keynes predicted that, by century’s end, technology would have advanced sufficiently that countries like Great Britain or the United States would have achieved a 15-hour work week. There’s every reason to believe he was right. In technological terms, we are quite capable of this. And yet it didn’t happen. Instead, technology has been marshaled, if anything, to figure out ways to make us all work more. In order to achieve this, jobs have had to be created that are, effectively, pointless. Huge swathes of people, in Europe and North America in particular, spend their entire working lives performing tasks they secretly believe do not really need to be performed. The moral and spiritual damage that comes from this situation is profound. It is a scar across our collective soul. Yet virtually no one talks about it.

    Read More > STRIKE! Magazine ‚Äď On the Phenomenon of Bullshit Jobs

    I have never read it explained better that.

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    • Ever read articles about the Kung!? The exclamation point is part of the word–no English equivalent exists. They only work 15 hours a week hunting and gathering. At the end of a book called Off, the narrator and his wife find how to support their family working 30 hours a week combined.

      Of course there are trade offs. The Kung! live in tents and move around, owning little but their loincloths and a very few primitive tools they hold as common property. The family in Off rejects cars, the internet, television and limits electricity. They also do a lot of work that doesn’t pay. Gardening, canning, sewing clothes, home carpentry.

      If we wanted to be semi-luddites, grow our own food, shoot our own meat, mend all our clothes till the cloth falls apart–we could get by on less than $600 a month. Or less than 20 hour work weeks.

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  3. The problem with studies like these is that capitalism is held as a constant. It’s assumed that people should be forced to sell their labor on a market in order to survive. I don’t happen to agree with that premise at all, and to me evidence such as this looks like great additional proof that abolishing capitalism has to be part of our goal as mental health activists / anti-psychiatric campaigners. Even Whitaker et al sort of got to this point without realizing it‚ÄĒthey reached the “end” of these “fixes,” lifestyle and self-management fixes, essentially, when they called for us to look at corruption as the next step. Well, to me it’s not about corruption, but the move to larger structures IS the right move… capitalism IS NOT SUSTAINABLE, either for the Earth, or for humans, who simply are not meant to bear these stresses of wage labor, hyper-individualism, and industrialized food, art, & culture.

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