Individual differences in empathy-related responses in early childhood: A person-centred approach.

The detrimental effects of mental illness on individuals, families and society can be severe, both in terms of well-being and work-related costs. According to the World Health Organization (WHO) common mental disorders (CMDs) encompass two primary diagnostic categories: depressive disorders and anxiety disorders. These conditions show high prevalence across the world population []. According to OECD, CMDs such as depression, anxiety disorders and alcohol and drug use disorders, affect more than one in six people across the European Union in any given year. Besides the impact on people’s health and well-being, the report estimates the total costs of mental ill-health at over EUR 600 billion – or more than 4% of GDP – across the 28 EU countries []. A large part of these costs is due to lower employment rates and lower productivity. Studies find that people with CMDs have adverse labour market outcomes than people without any mental disorders (for details, see []). CMDs among the working-age population is a critical concern for labour market and social policies across several OECD countries []. CMDs can be associated to labour market outcomes through multiple pathways. However, causal analyses of the relationship between CMD and labour market outcomes are complicated because of omitted variable bias and reverse causality due to potential endogeneity of CMDs. Omitted variable bias arises due to “third” factors (e.g., genetic endowments, cognitive ability, childhood circumstances, personality) that are correlated with both CMDs and labour market outcomes, while reverse causality occurs when lack of employment or reduced earnings worsen mental health []. Endogeneity concerning CMDs and labour market outcomes are analytically challenging. It is difficult to perform unbiased estimation of the impact of CMDs on labour market outcomes, i.e., to compare the labour market performance differences between healthy individuals and people with CMDs. Having such complexities in mind, our point of departure here is to focus on whether quality primary care is associated with labour market attachment for people with CMDs. Continuity of care (CoC) has been considered a core value of primary care services [, ] and as such represents an important indicator of the quality of services provided. Recent research shows that higher level of continuity of regular general practitioners (RGPs) care is associated with reduced use of emergency and specialist health care [–] with improved compliance with medication prescriptions [], and lower mortality [, ]. Evidence also suggests that continuity with RGPs care is strongly associated with greater patient satisfaction with care (e.g., []. A recent registry-based observational study in Norway also echoed similar findings – continuity of GP care is significantly associated with lower mortality, fewer acute hospital admissions and lower use of emergency (out-of-hours) services [].