The impact of social safety net policies on mental health and suicide outcomes in the United States: A scoping review

Existing evidence indicates that there are reciprocal relationships between economic insecurity and poor mental health and suicidal behavior. In the United States, prior research shows that state and federal policies that increase social safety net program benefits or eligibility contribute to improved economic security. Thus, these policies may affect mental health and suicide outcomes. The aim of this scoping review was to synthesize the state of the evidence on the impact of state and federal social safety net policies on mental health, suicidal behavior, and suicide death. Of 64 identified studies, state or federal social safety net policies examined included those specific Earned Income Tax Credits (EITC; N = 14), minimum wage (N = 11), paid family or sick leave (N = 9), the 2021 Child Tax Credit (CTC; N = 8), the Supplemental Nutrition Assistance Program (SNAP; N = 6), unemployment insurance benefits (N = 5), Temporary Assistance for Needy Families (TANF; N = 3), economic stimulus payments (N = 2) and eviction moratoriums (N = 2) during the COVID-19 pandemic, and multiple programs (N = 4). Most studies examined a single policy (N = 60), and more studies examined mental health outcomes (N = 53) than suicide outcomes (N = 15). Most studies that examined state or federal EITC, paid family or medical leave, the 2021 CTC, SNAP, TANF, unemployment insurance benefit, COVID-19 economic impact payment, and COVID-19 eviction moratorium policies found decreases in at least one measure of poor mental health, suicidal behavior, or suicide death. Studies that examined state minimum wage policies had mixed results. This body of research can be used to inform current policy debates and advance evidence-driven policymaking.