Psychological Barriers to Participation in the Labor Market: Evidence from Rural Ghana

Leandro Carvalho, Damien de Walque, Crick Lund, Heather Schofield, Vincent Somville and Jingyao Wei

No 11271, Policy Research Working Paper Series from The World Bank

Abstract: Mental health conditions are strongly associated with reduced labor market participation, but the underlying channels through which such conditions impact labor supply remain unclear. This paper reports on a two-phase study decomposing this relationship by examining (i) job take-up decisions; (ii) labor supply, output, and earning conditional on job take-up; and (iii) quit rates. In Phase 1, women in rural Ghana were asked whether they would be willing to take up a cash-for-work job during the lean season when alternative work is scarce. The findings show that individuals with depression and anxiety, which are common in this population, are much more likely to decline work offers outside the home but equally likely to accept work-from-home positions. In Phase 2, jobs at home were randomly offered to those who were willing to work from home, avoiding selection effects. Neither depression nor anxiety predicted work completion, income, or quit rates. These findings suggest that poor mental health may harm labor market outcomes in traditional jobs outside the home via reduced take-up, above and beyond the established negative impacts of mental health on productivity in work outside the home. The results also suggest an alternative approach to improving labor market outcomes for those in poor mental health: work-from-home opportunities, which are not associated with lower take-up or lower productivity on the job for those in poor mental health.

Date: 2025-12-03
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