ArticleThe Lancet. Public health2020
Effects on mental health of a UK welfare reform, Universal Credit: a longitudinal controlled study.
Article in The Lancet. Public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
52 citing papers in PubMed, 3 syntheses or guidelines pooled it, 153 citations in OpenAlex.
- What works for whom: a systematic review of inequalities in inclusion and effectiveness of social interventions for mental ill- health.Social psychiatry and psychiatric epidemiology · 2026Pooled it
- Preventing depression in high-income countries-A systematic review of studies evaluating change in social determinants.PloS one · 2025Pooled it
- National or population level interventions addressing the social determinants of mental health - an umbrella review.BMC public health · 2021Pooled it
- Guide to recent advances in difference-in-differences methodology for population health studies.Journal of epidemiology and community health · 2026Article
- Health, poverty and employment effects of cutting income replacement benefits for the disabled: a difference-in-differences analysis of the 2017 welfare reforms.Journal of epidemiology and community health · 2026Article
- The impact of universal credit on mental, physical, and financial well-being: longitudinal evidence from the UK household longitudinal survey.Social psychiatry and psychiatric epidemiology · 2026Article
- Effects of the Liverpool Citizens Support Scheme on mental health-related service utilisation: evidence from a natural experiment using instrumental variable analysis.BMC public health · 2026Article
- Social isolation in mid-life: associations with psychological distress, life satisfaction and self-rated health in two successive British birth cohorts.Social psychiatry and psychiatric epidemiology · 2026Article
- Multiple trajectories of family adversity and poverty and adolescent self-harm and suicide attempts: findings from the UK Millennium Cohort Study.Child and adolescent psychiatry and mental health · 2026Article
- Impacts of the Universal Credit welfare reform on well-being: a natural experiment study using UK population survey data.BMJ public health · 2026Article
- The Associations Between Income and Depression: A Cross-National Analysis.Depression and anxiety · 2026Article
- Understanding changes to life expectancy and inequalities in the UK, Germany, and other high-income countries.Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2025Review
- Moralisation, stigmatisation, and downstream interventions: How symbolic violence sustains geographic inequalities in deaths of despair in England.Social science & medicine (1982) · 2025Article
- Development and Validity Evaluation of the Index of Social Work Process in Promoting Social Participation of Welfare Recipients (SWP-PSP) in Japan.International journal of environmental research and public health · 2025Article
- 'It Is Like a Cross-Stitch … All Joined Together But Not Making a Very Nice Pattern': A Qualitative Study of Patient Perspectives on Physical Health Inequalities in Severe Mental Illness.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- The impacts of Liverpool Citizen's Advice on Prescription (CAP) on mental health outcomes- an Instrumental Variable (IV) approach.SSM - population health · 2025Article
- A new era of inequality: profound changes to mortality in England, Scotland, and 10 major British cities.European journal of public health · 2025Article
- Using natural experiments to evaluate population health and health system interventions: new framework for producers and users of evidence.BMJ (Clinical research ed.) · 2025Article
- Deep reinforcement learning can promote sustainable human behaviour in a common-pool resource problem.Nature communications · 2025Article
- Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
6 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundUniversal Credit, a welfare benefit reform in the UK, began to replace six existing benefit schemes in April, 2013, starting with the income-based Job Seekers Allowance. We aimed to determine the effects on mental health of the introduction of Universal Credit.
methodsIn this longitudinal controlled study, we linked 197 111 observations from 52 187 individuals of working age (16-64 years) in England, Wales, and Scotland who participated in the Understanding Society UK Longitudinal Household Panel Study between 2009 and 2018 with administrative data on the month when Universal Credit was introduced into the area in which each respondent lived. We included participants who had data on employment status, local authority area of residence, psychological distress, and confounding variables. We excluded individuals from Northern Ireland and people out of work with a disability. We used difference-in-differences analysis of this nationally representative, longitudinal, household survey and separated respondents into two groups: unemployed people who were eligible for Universal Credit (intervention group) and people who were not unemployed and therefore would not have generally been eligible for Universal Credit (comparison group). Using the phased roll-out of Universal Credit, we compared the change in psychological distress (self-reported via General Health Questionnaire-12) between the intervention group and the comparison group over time as the reform was introduced in the area in which each respondent lived. We defined clinically significant psychological distress as a score of greater than 3 on the General Health Questionnaire-12. We tested whether there were differential effects across subgroups (age, sex, and education).
findingsThe prevalence of psychological distress increased in the intervention group by 6·57 percentage points (95% CI 1·69-11·42) after the introduction of Universal Credit relative to the comparison group, after accounting for potential confounders. We estimate that between April 29, 2013, and Dec 31, 2018, an additional 63 674 (95% CI 10 042-117 307) unemployed people will have experienced levels of psychological distress that are clinically significant due to the introduction of Universal Credit; 21 760 of these individuals might reach the diagnostic threshold for depression.
interpretationOur findings suggest that the introduction of Universal Credit led to an increase in psychological distress, a measure of mental health difficulties, among those affected by the policy. Future changes to government welfare systems should be evaluated not only on a fiscal basis but on their potential to affect health and wellbeing.
fundingWellcome Trust, UK National Institute for Health Research, and Medical Research Council.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.