Parental Unemployment and Offspring Psychotropic Medication Purchases: A Longitudinal Fixed-Effects Analysis of 138,644 Adolescents

Abstract

Parental unemployment is associated with worse adolescent mental health, but prior evidence is primarily based on cross-sectional studies subject to reverse causality and confounding. We assess the association between parental unemployment and changes in adolescent psychotropic medication purchases with longitudinal individual-level fixed-effects models that control for time-invariant confounding. We use a large register-based panel of Finnish adolescents aged 13-20 in 1987-2012 (N = 138,644), with annual measurements of mothers' and fathers' employment and offspring psychotropic medication purchases. We assess changes in the probability of adolescent psychotropic medication purchases in the years before, during, and after the first episode of parental unemployment. There was no association between mother's unemployment and offspring psychotropic purchases in the fixed-effects models, suggesting this association is largely driven by unmeasured confounding and selection. By contrast, father's unemployment led to a significant 15-20% increase in the probability of purchasing psychotropic medication among adolescents even after extensive controls for observed and unobserved confounding. This change takes at least a year to emerge, but it is long-lasting and calls for policies that mitigate the harm of father's unemployment on offspring's mental wellbeing.