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(Not) Talking through our mental problems
One in eight people worldwide live with a mental health disorder, but 30\% to 70\% of those affected receive no treatment. To increase the uptake of mental health treatment and reduce the (economic) burden of mental health disorders, many countries have introduced programs facilitating access to talk therapy. Despite their widespread introduction and continued expansion, causal evidence on these programs' effectiveness is lacking. Using administrative data, I estimate the impact of a Dutch program that introduced talk therapy provided by nurse practitioners at GP practices nationwide. The reform increased talk therapy uptake by 6 percentage points among individuals seeking care. However, the increase in uptake also widened existing disparities in mental health care utilization. Additionally, in both the short and the long run, the use of preexisting types of mental health care was largely unaffected, and the labor market outcomes of individuals suffering from mental health problems did not improve.
Is delayed mental health treatment detrimental to life?
Differences between the US and the Netherlands
In this project, I examine further impacts of waiting times for mental health treatment, focusing on mortality. I compare mortality impacts in the Netherlands to those found in the US, and investigate why the mortality effects in the Netherlands are substantially smaller than those in the US.
The long-term consequences of mental health screening in high school
While the prevalence of mental health issues is high during childhood, only half of all children suffering from these issues receive treatment. The uptake of treatment is lower among children with low SES and/or migration backgrounds. This could potentially further increase inequality in later-in-life outcomes. This project analyses the introduction of preventative mental health screening for all 15/16-year-old high school students in the Netherlands. As a first step, (the heterogeneity in) the impact on the actual uptake of treatment is estimated. The second step examines whether preventive mental health screening also has long-term (10 years) effects on educational and labour market outcomes.
Sick or Unemployed? Examining Transitions into Sickness Insurance at Unemployment Benefit Exhaustion
Joint with Pierre Koning
Submitted
Spikes in exits at unemployment insurance (UI) benefit exhaustion into other benefit schemes such as sickness insurance (SI) are well-documented. These spikes could be driven by relatively healthy workers maximizing their total duration of benefit receipt, or workers in ill health who remain on UI while incapable of working. While the first explanation calls for a stricter SI and UI system, the second highlights the need for increased information provision. We study the importance of these explanations by first documenting a spike in exits into SI at UI benefit exhaustion in the Netherlands. Comparing detailed health and labor market characteristics of exit cohorts, we show that the spike is unlikely to be driven by maximizing behavior of relatively healthy workers. Instead, our results point to catch-up of initial non-take-up of SI by workers with substantial mental and physical health conditions. This opposes earlier work on substitution between UI and SI/DI.
No longer working on-papers
Activating rejected DI applicants: The impact of additional reintegration services
Policy report for Dutch parliament: https://www.tweedekamer.nl/downloads/document?id=2025D03096
Joint with Pierre Koning
Individuals whose application for disability insurance (DI) benefits is rejected often end up on unemployment insurance (UI) benefits . Standard reintegration services offered to UI recipients are however often not effective for these rejected DI applicants. In this project, we evaluate a policy reform which increased the provision of reintegration services to rejected DI applicants in the Netherlands. While take-up of the reintegration services is substantial, we find no evidence of improvements in employment outcomes of rejected DI applicants.
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