Economic Downturns as a Public Threat to Mental Health Outcomes: A Systematic Review and Meta-Analysis

Background: While individual studies indicate that economic crises pose a significant threat to population mental health, the aggregated magnitude and variation of this impact across different contexts remain unclear. This systematic review and meta-analysis synthesizes global evidence on the mental health consequences of economic downturns. Methods: A systematic search of PubMed, EMBASE, Web of Science, Scopus, PsycINFO, and EconLit, alongside and relevant government health department websites was conducted in accordance with PRISMA guidelines. Studies published between 01 January 2000 and 18 December 2025 that examined mental health outcomes in relation to economic crises were eligible. A random-effects meta-analysis using Comprehensive Meta-Analysis (CMA) software was conducted to estimate pooled prevalence, with subgroup analyses conducted according to mental health outcome, geographic region, and economic crisis phase. Study quality was assessed using the Newcastle–Ottawa Scale, and risk of bias was evaluated using the robvis tool. Publication bias was assessed using funnel plots and Egger’s regression test. Results: Thirty-nine studies from 14 countries met the inclusion criteria. The pooled prevalence of adverse mental health outcomes associated with economic crises was 6.4% (95% CI: 4.1–10.1%). Subgroup analyses showed the highest pooled prevalence for self-harm (18.9%), followed by somatoform disorders (17.6%) and distress (14.7%). Marked geographic variation was evident, with higher pooled prevalence estimates reported in several European countries. Mental health burden differed by crisis phase, with the highest prevalence observed during the post-crisis period (16.3%), followed by the pre-crisis phase (7.6%), Conclusions: Economic crises are associated with a substantial and heterogeneous burden of mental health problems, particularly self-harm. The magnitude of impact varies by outcome type, geographic context, and crisis phase, with evidence suggesting delayed and sustained effects beyond the acute crisis period. These findings highlight the need to integrate mental health protection into economic crisis preparedness and recovery policies, including safeguarding mental health services, strengthening social safety nets during and after economic downturns, and implementing a dual strategy of preventive community support for distress and acute clinical intervention for high-risk cohorts. The study protocol was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) under registration number (CRD420251272042).