IDEAS home Printed from https://ideas.repec.org/a/eee/labeco/v94y2025ics0927537125000521.html
   My bibliography  Save this article

Hiring mental health professionals: Evidence from a large-scale policy in Brazil

Author

Listed:
  • Mrejen, Matías
  • Rocha, Rudi

Abstract

This paper evaluates the impact of a policy that promoted the hiring of mental health professionals in public healthcare services in Brazil by exploiting the staggered adoption of the program across municipalities. We find large positive effects on the employment of non-medical health professionals in healthcare facilities and on their production outputs, along with smaller effects on psychiatrist employment and dispensation of drugs. Lower scarcity of non-medical health professionals in the local labor market was associated with greater hiring effects, while substitution of incumbent workers and spillovers across health facilities, sectors and regions did not play any significant role. Despite hiring efforts, however, no significant impact is observed on related mortality, hospitalizations, or sick leave days. Results suggest an increased availability of employed skilled professionals might not be enough to curb more extreme adverse health outcomes.

Suggested Citation

  • Mrejen, Matías & Rocha, Rudi, 2025. "Hiring mental health professionals: Evidence from a large-scale policy in Brazil," Labour Economics, Elsevier, vol. 94(C).
    • Handle: RePEc:eee:labeco:v:94:y:2025:i:c:s0927537125000521
    DOI: 10.1016/j.labeco.2025.102728
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0927537125000521
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.labeco.2025.102728?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Francisco Costa & Letícia Nunes & Fabio Miessi Sanches, 2024. "How to Attract Physicians to Underserved Areas? Policy Recommendations from a Structural Model," The Review of Economics and Statistics, MIT Press, vol. 106(1), pages 36-52, January.
    2. Bladimir Carrillo & Jose Feres, 2019. "Provider Supply, Utilization, and Infant Health: Evidence from a Physician Distribution Policy," American Economic Journal: Economic Policy, American Economic Association, vol. 11(3), pages 156-196, August.
    3. Mateus Dias & Luiz Felipe Fontes, 2024. "The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil," American Economic Journal: Economic Policy, American Economic Association, vol. 16(3), pages 257-289, August.
    4. Sonia Bhalotra & Rudi Rocha & Rodrigo R. Soares, 2020. "Can Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," Working Papers 03, Instituto de Estudos para Políticas de Saúde.
    5. Romero Rocha & Rodrigo R. Soares, 2010. "Evaluating the impact of community‐based health interventions: evidence from Brazil's Family Health Program," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 126-158, September.
    6. Ernesto Dal Bó & Frederico Finan & Martín A. Rossi, 2013. "Strengthening State Capabilities: The Role of Financial Incentives in the Call to Public Service," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 128(3), pages 1169-1218.
    7. Cl'ement de Chaisemartin & Xavier D'Haultf{oe}uille, 2020. "Difference-in-Differences Estimators of Intertemporal Treatment Effects," Papers 2007.04267, arXiv.org, revised Dec 2024.
    8. Ashesh Rambachan & Jonathan Roth, 2023. "A More Credible Approach to Parallel Trends," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 90(5), pages 2555-2591.
    9. Jonathan Roth & Pedro H. C. Sant’Anna, 2023. "Efficient Estimation for Staggered Rollout Designs," Journal of Political Economy Microeconomics, University of Chicago Press, vol. 1(4), pages 669-709.
    10. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    11. Sant’Anna, Pedro H.C. & Zhao, Jun, 2020. "Doubly robust difference-in-differences estimators," Journal of Econometrics, Elsevier, vol. 219(1), pages 101-122.
    12. Nava Ashraf & Oriana Bandiera & Edward Davenport & Scott S. Lee, 2020. "Losing Prosociality in the Quest for Talent? Sorting, Selection, and Productivity in the Delivery of Public Services," American Economic Review, American Economic Association, vol. 110(5), pages 1355-1394, May.
    13. Garrett Anstreicher, 2021. "Does increasing health care access reduce disability insurance caseloads? Evidence from the rural United States," Health Economics, John Wiley & Sons, Ltd., vol. 30(4), pages 786-802, April.
    14. Sun, Liyang & Abraham, Sarah, 2021. "Estimating dynamic treatment effects in event studies with heterogeneous treatment effects," Journal of Econometrics, Elsevier, vol. 225(2), pages 175-199.
    15. Jose A. Puppim De Oliveira & Yijia Jing & Paul Collins & Evan M. Berman, 2015. "HRM in Development: Lessons and Frontiers," Public Administration & Development, Blackwell Publishing, vol. 35(2), pages 113-127, May.
    16. Erika Deserranno, 2019. "Financial Incentives as Signals: Experimental Evidence from the Recruitment of Village Promoters in Uganda," American Economic Journal: Applied Economics, American Economic Association, vol. 11(1), pages 277-317, January.
    17. Callaway, Brantly & Sant’Anna, Pedro H.C., 2021. "Difference-in-Differences with multiple time periods," Journal of Econometrics, Elsevier, vol. 225(2), pages 200-230.
    18. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    19. Rudi Rocha & Isabela Furtado & Paula Spinola, 2021. "Financing needs, spending projection, and the future of health in Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1082-1094, May.
    20. Mora-García, Claudio A. & Pesec, Madeline & Prado, Andrea M., 2024. "The effect of primary healthcare on mortality: Evidence from Costa Rica," Journal of Health Economics, Elsevier, vol. 93(C).
    21. Edward N. Okeke, 2023. "When a Doctor Falls from the Sky: The Impact of Easing Doctor Supply Constraints on Mortality," American Economic Review, American Economic Association, vol. 113(3), pages 585-627, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Arne Henningsen & Guy Low & David Wuepper & Tobias Dalhaus & Hugo Storm & Dagim Belay & Stefan Hirsch, 2024. "Estimating Causal Effects with Observational Data: Guidelines for Agricultural and Applied Economists," IFRO Working Paper 2024/03, University of Copenhagen, Department of Food and Resource Economics.
    2. Isabelle Chort & Berk Öktem, 2024. "Agricultural shocks, coping policies and deforestation: Evidence from the coffee leaf rust epidemic in Mexico," American Journal of Agricultural Economics, John Wiley & Sons, vol. 106(3), pages 1020-1057, May.
    3. Chen, Shuai & Ge, Erqi, 2024. "The Anti-Corruption Campaign and the Inter-Generational Transmission of Working in Bureaucracy: Evidence from China," GLO Discussion Paper Series 1159 [rev.], Global Labor Organization (GLO).
    4. Tamara Bischof & Boris Kaiser, 2021. "Who cares when you close down? The effects of primary care practice closures on patients," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2004-2025, September.
    5. Heeyun Kim, 2024. "A Fad or the New Norm for Student Access Today? Evaluating Enrollment Outcomes of Holistic Admissions in South Korea," Research in Higher Education, Springer;Association for Institutional Research, vol. 65(5), pages 1040-1064, August.
    6. Valentin Cocco & Raja Chakir & Lauriane Mouysset, 2024. "Guilty or scapegoat? Land consolidation and the hedgerow decline," Working Papers hal-04658788, HAL.
    7. Ben Deaner & Chen-Wei Hsiang & Andrei Zeleneev, 2025. "Inferring Treatment Effects in Large Panels by Uncovering Latent Similarities," Papers 2503.20769, arXiv.org, revised Mar 2025.
    8. Philipp Barteska & Jay Euijung Lee, 2024. "Bureaucrats and the Korean export miracle," Discussion Papers 2024-11, Nottingham Interdisciplinary Centre for Economic and Political Research (NICEP).
    9. Bhorat, Haroon & Köhler, Timothy, 2025. "The labour market effects of cash transfers to the unemployed: Evidence from South Africa," World Development, Elsevier, vol. 188(C).
    10. Mateus Dias & Luiz Felipe Fontes, 2024. "The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil," American Economic Journal: Economic Policy, American Economic Association, vol. 16(3), pages 257-289, August.
    11. Francesconi, Marco & Sonedda, Daniela, 2024. "Does Weaker Employment Protection Lower the Cost of Job Loss?," IZA Discussion Papers 17374, Institute of Labor Economics (IZA).
    12. Balia, S.; & Brau, R.; & Pau, S.;, 2025. "One plus one makes less than two? Consolidation policies and mortality in the Italian NHS," Health, Econometrics and Data Group (HEDG) Working Papers 25/02, HEDG, c/o Department of Economics, University of York.
    13. Roth, Jonathan & Sant’Anna, Pedro H.C. & Bilinski, Alyssa & Poe, John, 2023. "What’s trending in difference-in-differences? A synthesis of the recent econometrics literature," Journal of Econometrics, Elsevier, vol. 235(2), pages 2218-2244.
    14. Philipp Barteska & Jay Euijung Lee, 2025. "Personnel is policy (implementation): Bureaucrats and the Korean export miracle," CEP Discussion Papers dp2099, Centre for Economic Performance, LSE.
    15. Charris, Carlos & Branco, Danyelle & Carrillo, Bladimir, 2024. "Economic shocks and infant health: Evidence from a trade reform in Brazil," Journal of Development Economics, Elsevier, vol. 166(C).
    16. Khalil, Umair & Sanfelice, Viviane, 2025. "Housing Improvement and Crime," Journal of Public Economics, Elsevier, vol. 242(C).
    17. repec:osf:socarx:hfa8s_v1 is not listed on IDEAS
    18. Álvaro Robério de Souza Sá & Danyelle Karine Santos Branco, 2024. "Social fund and infant mortality: Evidence from an anti‐poverty policy in Northeast Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 674-695, April.
    19. Malisa, Amedeus, 2024. "Grand-parenthood and retirement," Labour Economics, Elsevier, vol. 90(C).
    20. Chen, Shuai & Ge, Erqi, 2022. "The Anti-Corruption Campaign and the Inter-Generational Transmission of Working in Bureaucracy: Evidence from China," GLO Discussion Paper Series 1159, Global Labor Organization (GLO).
    21. Bellégo, Christophe & Benatia, David & Dortet-Bernadet, Vincent, 2025. "The chained difference-in-differences," Journal of Econometrics, Elsevier, vol. 248(C).

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • J48 - Labor and Demographic Economics - - Particular Labor Markets - - - Particular Labor Markets; Public Policy

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:labeco:v:94:y:2025:i:c:s0927537125000521. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/labeco .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.