The Psychosocial Value of Employment: Evidence from a Refugee Camp

• Employment significantly improved psychosocial outcomes for participants.
  • Participants who were offered part time employment opportunities (e.g the “employment” or “work” group) showed a 0.21 unit improvement in their psychosocial index compared to the control group, significant at the 1 percent level.
  • They also exhibited substantial decreases in depression and anxiety symptoms, while experiencing improvements in life satisfaction, sociability, self-worth, and feelings of control and stability.
  • These results are attributable to the non-monetary aspects of work.
• The employment group saw larger health benefits than the cash group.
  • The work group reported more healthy days, improved cognitive function, alongside increased risk tolerance.
  • It found that an additional day away from work was associated with a reduction in well-being and an increase in stress – suggesting the experience of working, not just the employment status, has value.
• Workers themselves recognize and appreciate the psychosocial value of employment.
  • 70% of the work group valued the non money-related benefits of having a job more than not working at all.
  • 55% think the non-monetary benefits are worth more than 200 BTD, an equivalent to the average savings they had initially.
• Employment appears to offer greater psychological benefits to men than to women.
  • Men in the employment group showed significant reductions in depression when employed, but men in the cash group showed a slight increase in depression with cash alone. Women in both the cash and work groups experienced moderate depression reductions.
• Both cash and work increased women’s perceptions of their power within the household and their intolerance for intimate partner violence.
  • The employment intervention shifted beliefs around whether women should be allowed to work outside the home.

Finally, a majority of the refugees (66%) were willing to work without pay, even forgoing a significant cash transfer. Therefore, this research suggests that policymakers could leverage work programs to alleviate both material and psychological poverty. At the same time, however, these findings highlight a need for labor regulation, including legal protections like wage floors, especially in restrictive labor environments.

Researchers conducted their study across three Bangladesh refugee camps. Five households per block were selected from nonadjacent blocks to minimize spillover. The chosen household head was either male or female, resulting in a one-third female sample from a total of 745 individuals.

745 individuals from 149 blocks were randomly assigned to control, cash, or work groups, with gender stratification. The control group received 50 BTD (US$0.60) weekly for survey

participation, the cash group received 450 BTD (US$5.30) weekly, and the work group was offered employment and was paid 150 BTD (US$1.77) per day of work and were assigned an average of three days of work a week, equating to an average of 450 BTD per week, matching the cash group.

Employment Intervention – The work group participants engaged in data collection on same-sex neighbors' activities four times a day, a task balancing physical and mental effort, had a social component, and was purposeful, reflecting the core aspects of labor in economic theory. The job was part-time and didn't require conversations with neighbors. Participants were informed that the objective of this employment, framed to echo the inherent community-centric purpose in camp life, was to provide NGOs with better understanding of the refugee experience to improve their services.

A baseline survey was conducted in November 2019, an endline survey in February 2020, and an additional seven weekly midline surveys before payment was disbursed. A follow-up survey six weeks post-intervention ensured no negative mental health impacts. Attrition was low (2%) for the endline and follow-up surveys and it was uniform across treatment arms.

The primary focus was psychosocial well-being, assessed through seven measures: depression, stress, life satisfaction, locus of control, sociability, self-worth, and stability. Other areas considered include physical health, cognitive function, economic decision-making, time use, and consumption. The study used two methods for multiple hypothesis testing. Firstly, it presents the main outcome, psychosocial well-being, and other outcomes like cognitive index, household power index, and work rights index as inverse-covariance weighted index variables. Secondly, it reports the sharpened false discovery rate q-values for all outcomes in a specific table, controlling for the expected proportion of Type I errors.