The mental anguish of the long-term unemployed

Marilyn Puder-York spends her days coaching successful corporate executives on how they can get even further ahead. But for years, the New York-area psychologist counseled long-term unemployed people on how to deal with their depression while they struggled to land another job.

While many of her clients proved resilient in bouncing back and "reinventing" themselves, others had a far more difficult time and tended to become panicky, "very depressed," and "angry victims." For those who suffered the double trauma of losing their jobs and then no longer being able to support themselves and their families, "That really slams your self-esteem," she said in an interview on Thursday.

"It's one thing to lose a job, but it's another not to be able to manage," she said.

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Puder-York, an executive coach and author, had a front-row seat observing the mental anguish of people who were unemployed for months if not years. Today, the estimated 3.6 million long-term unemployed account for 2.3 percent of the nation's workforce, which is still a historically high level more than five years after the start of the economic recovery.

Unemployed workers are twice as likely as their employed counterparts to experience psychological problems such as depression, anxiety, psychosomatic symptoms, low subjective well-being, and poor self-esteem, according to the American Psychological Association.

A comprehensive study of long-term unemployed published by Rutgers University's John J. Heldrich Center for Workforce Development in 2011 found that the vast majority of unemployed workers experienced stress in their relationships with family and friends and that at least 11 percent reported seeking professional help for their depression within the previous 12 months.

One in two of the respondents in the two-year national study said they began avoiding friends and associates out of a sense of shame and embarrassment — a self-imposed isolation that hurt their ability to network to find work.

"Because of the persistence of high levels of long term unemployment there are millions of people who are suffering from mental health problems and many of them are going untreated by professionals," Carl Van Horn, a professor of public policy and economics at Rutgers and head of the Heldrich Center, said this week.

"Losing a job is more than just a financial crisis for people," Van Horn says. "It creates numerous other damage: stress, anxiety, substance abuse, fights, and conflicts in the family and feelings of embarrassment and depression."

The plight of many of the long-term unemployed became even direr in late December after Congress allowed jobless benefits to expire for more than 1.6 million Americans. Senate Majority Leader Harry Reid (D-NV) vowed that renewing an extension of federal unemployment insurance benefits would be the first order of business when the Senate returned in January, but Republicans have blocked Democratic efforts to extend the program for those who exhausted their 26 weeks of state benefits.

"There are now 1.6 million unemployed Americans cut off and 2.3 million children affected," said Sarah Ayres, a policy analyst with the liberal Center for American Progress. "This money is going to people who are going to spend it — they're putting it right back into the economy. This is really a self-inflicted economic wound."

The number of individual recipients whose benefits expire runs to about 70,000 a week.

The mental health crisis among the long term unemployed rarely gets much attention, although Van Horn has described the combination of long-term unemployment and diminished government support as "a silent mental health epidemic."

Long-term unemployment frequently causes depression, drug and alcohol abuses, spousal abuse, divorce, and even suicide. Many of these unemployed Americans couldn't afford to seek professional help because they lost their employer-provided health care insurance when they were laid off. At the same time, federal, state, and local governments cut back on spending for mental health clinics and outreach in response to budget crises spawned by the bad economy.

A 2013 Urban Institute study on the consequences of long-term unemployment found, "The long-term unemployed also tend to earn less once they find new jobs. They tend to be in poorer health and have children with worse academic performance than similar workers who avoided unemployment."

Some of that problem is beginning to abate, as the economy gradually improves and many unemployed people now qualify for Medicaid or heavily subsidized health insurance under the Affordable Care Act.

Last November, the Department of Health and Human Services unveiled long-awaited final rules on parity in benefits and treatment to require private insurers to cover care for mental health and addiction in the same way they handled physical illness.

"It's a trend moving in the right direction," Van Horn said. "Folks who need professional help will have the access over the next few months or years."

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