Relationship between self-esteem and employment in people with severe mental illness: A systematic review and meta-analysis

BACKGROUND: Results from past research on the association between work outcomes and self-esteem were inconsistent. OBJECTIVE: This study aimed to review and quantify the correlation between employment variables and self-esteem in people with severe mental illness. METHOD: The first electronic database search was performed between November 5 and November 12, 2021. A second search update was completed in September 2023. Studies that reported a correlation between at least one employment-related variable and self-esteem were subsequently verified. Pooled effect sizes were calculated with random-effects models by aggregating Fisher’s Z-to-Pearson r transformed correlations. RESULTS: The database search generated 3,547 reports. Thirteen and seven reports were included in the qualitative review and the meta-analyses, respectively. Meta-analyses results based on data from 1,065 participants suggested a positive albeit small correlation between employment variables and self-esteem in people with severe mental illness (r = 0.26, p = .002 for global self-esteem; r = 0.21, p < 0.001 for total self-esteem). It was found through systematic review that greater confidence in personal capacity, more opportunities on novel activities, and positive affirmation from coworkers were some potential mechanisms underlying self-esteem improvement following work. CONCLUSION: Future research on employment in severe mental illness would benefit from including adapted self-esteem measures and can build on this work by examining the relationships between specific employment variables (e.g., job acquisition, job tenure) and self-esteem.