CIDACS

Investigating the Impact of Cash Transfers on Youth Mental Health

An ongoing project (2021-2026).

The Aim of the Study: 

Led by Dr. Daiane Machado (PI, Harvard Medical School), the CIDACS study aims to uncover how conditional cash transfers influence mental illnesses and suicide among the youth by identifying key social drivers and mechanisms. Conditional cash transfers are amounts given to households on the condition that they comply with certain pre-defined requirements. 

The Background:

Physical, emotional, and social changes, including exposure to poverty, abuse, or violence, increase youth vulnerability to mental illness. Addressing these issues can lead to improved population-level outcomes and greater cost-effectiveness for health services. Cash transfer programs have been a promising way to address social drivers of poor mental health.

However, it is still unclear which pathways and mechanisms explain the association between socioeconomic support and lowering the burden of mental illness among the youth.

The Project Plan:

This study analyzes large datasets using robust methodologies to identify the association between being beneficiaries of the Conditional Cash Transfer program, called the Bolsa Família Program (BFP), and mental illness and its long-term effects. This analysis will assist in:

• testing four mechanisms and pathways (i. reducing parental mental illness; ii. increasing school retention; iii. reducing exposure to violence; iv. decreasing impulsivity) of the social-economic intervention on reducing mental illness and suicide among youth;
   
• evaluating whether equity is a moderator of the effectiveness of the cash transfer program;
   

• investigating early-life exposures and intergenerational aspects to forecast the impact of socioeconomic changes and the mitigation effects of cash transfers in Brazil until 2030, and modeling the impact of the current COVID-19-related economic recession.

   

Supporters and Project Duration:
 

CIDACS is supported by the National Institute of Mental Health (NIMH) and the National Institutes of Health (NIH), USA, and runs from 2021 to 2026. Collaborators include the London School of Hygiene and Tropical Medicine, Virginia Commonwealth University (T32 NIAAA), Virginia Institute for Psychiatric and Behavioral Genetics, and the University of Melbourne.

To read more about the project, visit: NIH Report

Findings:

CIDACS has produced a substantial body of published work. See the publications section below to learn more.

Next Steps: 

The team is continuing analysis through 2026, including modeling the long-term impact of the COVID-19 economic recession on youth mental health outcomes and completing equity analyses of BFP effectiveness across subgroups.

Publications:

•  April 2026: Cash Transfers and Psychiatric Hospitalization for At-Risk Populations in Brazil. JAMA Network Open.
•  March 2025: Associations between the Bolsa Familia conditional cash transfer programme and substance use disorder hospitalisations: a quasi-experimental study of the 100 Million Brazilian Cohort. Lancet Global Health.
• December 2024: Conditional cash transfers and mortality in people hospitalised with psychiatric disorders: A cohort study of the Brazilian Bolsa Familia Programme. PLOS Medicine.
•  October 2024: Risk of psychiatric hospitalization in low-income youth: longitudinal findings from the 100 Million Brazilian Cohort. International Journal of Epidemiology.