Depression Symptoms, Employment, and Household Economic Outcomes: Evidence from the MIND-ECON Trial in South Africa

Evidence on the causal relationship between mental health and economic outcomes remains limited, especially in low- and middle-income country (LMIC) settings. This paper examines whether improvements in depression symptom severity translate into improved economic outcomes among patients with co-occurring HIV and/or diabetes in South Africa, using exogenous variation from a mental health intervention. The intervention significantly reduced depressive symptoms. The reduced-form estimates suggest an increase in employment, while the instrumental-variable estimates are consistent with improvements in income and household expenditure that remain robust under conservative assumptions about selective attrition. Overall, the findings suggest that improved mental health may contribute to better labour market and household economic outcomes, but that complementary policies are likely needed to generate larger gains in settings characterised by high structural unemployment.