TY - JOUR

T1 - OP63 The mental health impact of a local welfare scheme in liverpool: an instrumental variable (IV) analysis

AU - Song, Huihui

AU - Coombes, Emma

AU - Kaloudis, Harris

AU - Barr, Benjamin

PY - 2025/8/24

Y1 - 2025/8/24

N2 - Background A local welfare scheme, Liverpool Citizens Support Scheme (LCSS), was introduced in 2013 by Liverpool City Council to mitigate acute financial hardship in one of the most disadvantaged areas in the UK. It provides essential household items such as furniture and white goods to individuals without immediate funds. The scheme distributed £4,152,833 in funds to households in need during 2022–2024.LCSS has historically been available to all Liverpool residents meeting certain financial criteria, however, in April 2023 the council implemented a policy change to control expenditure by discontinuing support to those living in social housing. Following this change, Registered Social Landlords were expected to support their tenants by providing furniture through service charges reimbursed via Universal Credit. This policy change serves as an exogenous shock, allowing us to assess the impact of welfare reform on mental health.Data This study utilised data from Liverpool City Council on LCSS funding and awards, available quarterly from 2022–2024. LCSS data were linked at the Lower Super Output Area (LSOA) level with Census data on tenant structure (private and social) and unemployment rates.Our outcome measure was an LSOA level mental health index, which was generated using NHS primary and secondary care data on several variables including quantities of antidepressants prescribed and number of mental health-related general practitioner consultations. A Principal Component Analysis was undertaken on these health variables to construct a quarterly mental health index across Liverpool.To estimate the impact of changes in LCSS funding on the mental health index, we initially employed a panel regression model with fixed effects. To mitigate potential endogeneity concerns we then examined instrument exposure to the intervention using the interaction between the post-policy period and the proportion of social housing tenants living in an LSOA as an instrumental variable (IV).Results Both panel regression and IV analysis indicated that increased uptake of LCSS funding improved mental health. The IV analysis estimated the impact of LCSS funding on the mental health index as -0.0099 (95% CI: -0.017, -0.0028; p=0.006).Conclusion Our findings indicate that it is likely that welfare support from LCSS improved mental health, relative to what would have been expected in the absence of the intervention. Our study also highlights the potentially important role of local welfare initiatives for improving health and reducing health inequalities in economically disadvantaged areas.

AB - Background A local welfare scheme, Liverpool Citizens Support Scheme (LCSS), was introduced in 2013 by Liverpool City Council to mitigate acute financial hardship in one of the most disadvantaged areas in the UK. It provides essential household items such as furniture and white goods to individuals without immediate funds. The scheme distributed £4,152,833 in funds to households in need during 2022–2024.LCSS has historically been available to all Liverpool residents meeting certain financial criteria, however, in April 2023 the council implemented a policy change to control expenditure by discontinuing support to those living in social housing. Following this change, Registered Social Landlords were expected to support their tenants by providing furniture through service charges reimbursed via Universal Credit. This policy change serves as an exogenous shock, allowing us to assess the impact of welfare reform on mental health.Data This study utilised data from Liverpool City Council on LCSS funding and awards, available quarterly from 2022–2024. LCSS data were linked at the Lower Super Output Area (LSOA) level with Census data on tenant structure (private and social) and unemployment rates.Our outcome measure was an LSOA level mental health index, which was generated using NHS primary and secondary care data on several variables including quantities of antidepressants prescribed and number of mental health-related general practitioner consultations. A Principal Component Analysis was undertaken on these health variables to construct a quarterly mental health index across Liverpool.To estimate the impact of changes in LCSS funding on the mental health index, we initially employed a panel regression model with fixed effects. To mitigate potential endogeneity concerns we then examined instrument exposure to the intervention using the interaction between the post-policy period and the proportion of social housing tenants living in an LSOA as an instrumental variable (IV).Results Both panel regression and IV analysis indicated that increased uptake of LCSS funding improved mental health. The IV analysis estimated the impact of LCSS funding on the mental health index as -0.0099 (95% CI: -0.017, -0.0028; p=0.006).Conclusion Our findings indicate that it is likely that welfare support from LCSS improved mental health, relative to what would have been expected in the absence of the intervention. Our study also highlights the potentially important role of local welfare initiatives for improving health and reducing health inequalities in economically disadvantaged areas.

U2 - 10.1136/jech-2025-ssmabstracts.63

DO - 10.1136/jech-2025-ssmabstracts.63

M3 - Meeting abstract

VL - 79

SP - A31.2-A31

JO - Journal of Epidemiology and Community Health

JF - Journal of Epidemiology and Community Health

SN - 0143-005X

IS - Suppl. 1

ER -