THE IMPACT of unemployment on men's health was not an issue which received much attention during the Celtic Tiger years when the unemployment rate here hovered around the 4 per cent mark (roughly one worker in every 25).
Our unemployment rate during the boom years was so low in fact, that we congratulated ourselves on essentially having arrived at the utopian destination of full employment.
How times have changed. The unemployment rate reached 7.8 per cent in November (277,000 people) and Davy Stockbrokers recently forecasted that it may reach 12 per cent by 2010.
It is worth bearing in mind that for every 1 per cent increase, another 23,000 people are coming to terms with losing their jobs. Due to the downturn in the construction sector, men are bearing the main brunt of these job losses, accounting for up to 70 per cent of the total monthly increases in dole claimants in the past few months of this year.
Given this drastic deterioration in our economic situation, the impact of unemployment on men's health is set to become an increasingly important public health issue, according to observers.
The link between poor health and unemployment has been investigated since the Great Depression and most research now concurs that being out of work is detrimental to health and wellbeing. Various studies have established that losing your job results in lower self-esteem (Muller, 1993), greater anxiety and stress (Fagin, 1984) and a greater incidence of depression (Feather and O'Brien, 1986).
In the Republic, a recent Health Research Board trend analysis found that people who were unemployed were four times more likely to experience mental health problems than employed people (though it must be noted that in some cases mental health issues could be the cause of unemployment).
A University of Ulster report found that unemployed men experience higher levels of mental health symptoms than the general population, especially in the areas of depression, panic attacks and incidence of alcohol and drug misuse.
Why does unemployment have such serious health implications? In the first instance, the loss of income is a source of significant anxiety for the unemployed person and society in general recognises the devastating consequences of acute stress for our physiology.
Psychologists also believe that the non-financial benefits of work have a significant impact on wellbeing. In her research on the psychological impact of unemployment, Marie Jahoda established that work provides us with a structure to our day, social contacts, status, mental and physical activity, and a sense of purpose.
Clearly while independent financial security and (to a lesser extent) unemployment benefit payments go some way to alleviating income loss, the non-financial benefits of work are more difficult to replace.
The problem is compounded for men because our identity is closely linked to our careers. Though the image of "man as breadwinner" may be a little outdated, employment is still the dominant factor in male identity, influence, masculinity and self-esteem.
We are still classified by "what we do" as opposed to our personal characteristics and for that reason, the label "unemployed" undermines a central plank of our masculinity. Health and Safety Authority psychologist Patricia Murray believes that in Irish society, the male identity and image is still inextricably linked to work.
"Women just seem to have this dual role that they can fall back on to fulfil their emotional needs. If you see a man walking around Tesco at 2pm on a Wednesday, people will assume he's out of work. If you see a woman doing the same thing, nobody questions it."
Some psychologists argue that the loss of employment for a man is a shock that is akin to bereavement. "We have seen in the last week with the pork industry how your life can suddenly change over night," says retirement consultant Eamon Donnelly.
"It is the sheer shock of redundancy that is so stressful and we go through a lot of the same emotions as the grief cycle - shock, denial, anger, bargaining, depression and acceptance. It is also extremely stressful by the way to be working in an industry where you are waiting for the axe to fall."
Men fall back on their traditional coping mechanisms when they lose their jobs, according to occupational psychologist Joseph O'Mahony.
"In some cases they will isolate themselves and not talk about it at all and because they don't have the same stock of support resources that women have they tend to become remote. In other cases they will become angry and frustrated.
"We have worked with a lot of men in the last few months and they tend to lash out at politicians, the company, their managers. We try to help them see that this is something which happens to most people at some stage in their lives and that they need to use the support structures which are out there to get back on their feet."
O'Mahony believes that younger men who have never been through a recession before are finding it particularly tough. "It is the younger men that I would be more worried about to be honest. They have massive financial commitments and I think the older men who have been through it might be aware how a previous redundancy resulted in a positive life-change for them."
Although it is perhaps easy to understand why unemployment affects mental health, the links with physical ill-health are more controversial - still the evidence is compelling.
The Office of Population Censuses and Surveys (OPCS) longitudinal study found higher levels of mortality from lung cancer, suicide, accidents and heart disease among the unemployed, while other studies have found significant increase in attendance with GPs when workers were made redundant. Former editor of the British Medical Journal, Richard Smith, wrote in his book on the issue that "unemployment raises the chance that a man will die in the next decade by about a third".
Linn et al found that days in bed during a six-month period averaged 0.9 for employed and five for the unemployed; visits to the GP were five times higher and medication intake was twice as high.
"There is an intricate relationship between mental and physical health," says Dr Noel Richardson, director of the IT Carlow Centre for Men's Health Research. "We know that stress is very much related to physical conditions such as heart disease and high blood pressure so we should not be surprised that unemployment can cause health issues. It is perhaps less relevant whether they are mental or physical."
Amid all the doom and gloom it is important to emphasise that not all unemployed people are thus affected.
Numerous studies highlight the fact that the stress caused by unemployment is alleviated by a strong social support network. "I think for men who have solid relationships, a degree of financial security and good friends, they are well placed to deal with it," says O'Mahony.
All the psychologists who I spoke to were keen to emphasise that the health implications of unemployment are highly individual and person-specific.
"It's very complex," says the HSA's Patricia Murray. "The biggest predictor of the health outcome of unemployment is not the job the person had or how much money they were earning. It's their personality style and their ability to adapt and be flexible to the extremely difficult situation they are in."
Help at hand
• Do not blame yourself for being out of work. Accept that these are difficult times in the workplace and that there are loads of people in the same boat.
• Seek help in finding a new job. Fás will help you find new work or re-skill - www.fas.ie
• Jobseekers Advice is a free, independent website with information on all aspects of employment - www.jobseekersadvice.com.
• While you are looking for a new job think about voluntary work or returning to education. It will keep you busy and improve your CV.
• Make a budget so that you can see how much money you're going to be able to live on. Contact your local Money Advice Bureau if you need help in managing debt. 1890 283 438 or www.mabs.ie.
• Be flexible. Roles within the family will probably shift during this period. Try to keep up your regular routines as best you can. It's important to keep your life as rich as possible while you're looking for work. Work hard at maintaining contact with friends, family and former colleagues.
• Do not be afraid to express feelings to loved ones, including frustration, anger and despair.
• Take good care of yourself. Try to eat balanced meals and get plenty of exercise - walking/running, etc will not cost money and are excellent for mental and physical health.
• Get professional help if you are feeling depressed, particularly if you are depressed for a prolonged period, feel numb, empty-hearted or tired all the time. Contact an advice helpline such as Aware on 1890 303302 or the Samaritans on 1850 609090. For advice on redundancy and welfare issues, see www.redundancy.ie.