Why Poverty Can Lead To Poor Mental Health
People experience economic hardship as a result of a variety of difficult life situations, such as divorce, a death in the family, loss of job, etc. The resulting loss of income may lead to poverty in other essential resources, such as housing, education, and employment. Evidence indicates that poverty-and the material and social deprivation associated with it-is a primary cause of poor health among Canadians.14 As a result, ones quality of life is compromised, which has an impact on mental health. Depression and anxiety often follow this route of stress and strain.15
For persons who are poor and predisposed to mental illness, losing stabilizing resources, such as income, employment, and housing, for an extended period of time can increase the risk factors for mental illness or relapse.
Low Income & Its Effects On Mental Health
According to the CDC, 8.7% of people who have incomes below the poverty level report severe psychological distress.1
Poverty causes stressors such as insecurity and uncertainty about food, housing, and income. Low-income communities tend to have specific characterizations such as limited resources, poor houses, high crime and violence rates, and an inadequate school system, which are all associated with poor mental health outcomes.
On a family level, these stressors can cause an increased risk of mental health problems and substance abuse in the parents, which can lead to child abuse and neglect and in turn cause negative mental health impacts for the child.
On an individual level, poverty can lead to high stress and major physiologic responses, such as high blood pressure and high cortisol levels. With prolonged exposure to poverty, these responses turn into disruptions in brain functioning, which ultimately lead to both long-term physical and mental health consequences.
The Link Between Poverty And Mental Health
Poverty is a multidimensional phenomenon that encompasses a lack of ability to satisfy basic needs, resources, education, and physical and mental health.
I dont think society understands the cycle created by having a mental illness and living on the lowest of incomes, a woman suffering from bipolar disorder named Mandy told CNA Harriet Tinka. It is difficult to respond to my family needs. Every day is spent working out which bill l have to pay and which l can delay another month or so. It is so draining and stressful.
While having a stable income is not a guarantor of mental health, its clear that there are distinct correlations between mental health and economic status.
You dont have to live in poverty to experience mental health problems, Dean Burnett writes in The Guardian. Many wealthy, successful types have succumbed to them. But poverty is a much bigger risk factor for mental health problems, in the same way, that smoking is a bigger risk factor for lung cancer. Not every smoker gets lung cancer, and non-smokers are not immune to it, but smoking makes it far more likely.
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Gene By Environment Interactions: Schizophrenia And Depression
The factors listed above do not act in isolation to contribute to the development of psychological disorders, and the nature of gene by environment interactions is the subject of substantial research. Gene-environment interactions describe the phenomenon by which certain gene variants modulate the effects of environmental factors. However, environmental factors often cause epigenetic changes chemical modifications that affect how genes are expressed making it difficult to distinguish environmental from genetic effects. Increased interest in epigenetics has prompted modern psychiatric research to focus on biochemical mechanisms by which environmental factors may influence genetic expression and the onset of psychological disorders. The following studies illustrate the complex nature of gene by environment interactions by providing a sample of research on the causes of schizophrenia and depression, two of the priority mental health conditions identified by the World Health Organization.
Tackle Intersectional Stigma And Disadvantage
We must understand, research and tackle stigma in a much more sophisticated way by recognising that mental health stigma does not sit in isolation. We need to understand and address what Turan and colleagues define as intersectional stigma.34 Intersectional stigma explains the convergence of multiple stigmatised identities that can include ethnicity, gender, sexuality, poverty and health status. This can then magnify the impact on the person’s life. In this context, the reality is that you have a much greater chance of getting a mental health problem if you experience poverty. And if you do, then you will likely experience more stigma and discrimination. Its impact on your life will be greater, for example on precarious employment, housing, education and finances. It is harder to recover and the impact on family members may be magnified. Intersectional stigma remains poorly researched and understood,35 although the health impact of poverty stigma is now emerging as an important issue in studies in Glasgow and elsewhere.25
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The Importance Of Treatment
Many people with co-occurring disorders fail to seek treatment for a variety of reasons. While the federal government has made efforts to expand access to treatment, many residents living in poor communities avoid rehab because of the stigma, perhaps believing that simply being known to have sought treatment will make it harder for them to find employment.
Mental illness and addiction are heavily stigmatized in the United States. People struggling with one or both of these disorders often feel too ashamed or embarrassed to talk about their problems with loved ones or counselors. This reluctance is a major barrier to treatment among many Americans, including those living in poverty.
However, treatment saves lives. The Recovery Village offers evidence-based treatment to people of all socioeconomic backgrounds. With facilities located across the United States, The Recovery Village provides patients with detox services, inpatient care and aftercare resources. If you have a mental health or substance use disorder, .
How Mental Illness Contributes To Addiction
Addiction is a mental illness that changes the brains chemistry. Drugs and alcohol alter areas of the brain responsible for thinking, decision-making and pleasure. Individuals with a severe substance use disorder act compulsively, struggle to handle everyday tasks and endure a range of health problems.
Mental illness is inextricably linked to addiction. According to the Anxiety and Depression Association of America, about 20 percent of people in the United States with an anxiety or mood disorder also have a substance use disorder. Conversely, 20 percent of Americans with an anxiety or mood disorder deal with dependence or addiction.
People with mental health disorders, like bipolar disorder, often self-medicate using drugs or alcohol to numb their physical or psychological pain. Over time, they may rely on these substances to feel normal. When individuals who regularly engage in substance use exhibit compulsive behaviors despite the negative consequences, addiction may be present.
Drug use is more prevalent in poor communities than in wealthier ones. According to the Centers for Disease Control and Prevention, heroin use is nearly three times more common among families with an annual household income below $20,000 than among families making $50,000 or more each year.
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Exploring The Connection Between Poverty And Mental Illness
Improving a person’s economic situation reduces their risks of anxiety and depression, and addressing these common mental illnesses reaps economic benefits by increasing employment and an individual’s earnings, according to a new review of research.
In a published in the December 11 issue of Science, Matthew Ridley, a researcher at the Massachusetts Institute of Technology, and colleagues examine the accumulating evidence from a wide range of interdisciplinary studies that demonstrate a causal relationship between poverty and mental health.
Understanding the links between poverty and mental health matters can help policymakers design more effective policies to both improve mental health and reduce poverty, said Ridley and the authors an especially urgent consideration during COVID-19.
“The ongoing pandemic has severe adverse impacts on both poverty and mental health. COVID-19 has disproportionality affected the poor and may have lasting impacts on their economic and mental well-being,” said Ridley.
In the absence of support, those living in poverty in many places around the world are getting hit with a “triple disaster” not only are they navigating the risks of COVID-19, but also the compounding effects of poor psychological health and economic suffering caused by the pandemic.
The Determinants Of Mental Health And Wellbeing Are Largely About The Society We Live In Rather Than Medical
Mental health is, to a great extent, shaped by the social, economic, and physical environments in which people live. Inequalities in society are associated with a significant increased risk of mental ill health. Poverty is a key player.
People in poverty can face constant, high levels of stress, for example due to struggling to make ends meet, overcrowded or unsafe housing, fear of crime, and comparatively poor physical health. Poverty is clearly linked with a number of mental health problems, including schizophrenia, depression and anxiety, and substance misuse.
It’s a two-way street. Poverty can be both a cause and a consequence of mental ill health, e.g. where debilitating symptoms and stigma around mental illness have an impact on a persons income and ability to work.
This disadvantage starts before birth and accumulates throughout life.
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A Look At Mental Health Around The World
Mental health problems threaten quality of life at a large scale. Globally, depression is one of the leading causes of disability, and suicide is the fourth leading cause of death among 15-29 year olds.
And while many countries like Australia and the US are enacting measures to address mental health issues, there is still a global stigma that leads people to experience obstacles getting the help they need to thrive.
Heres a look at what mental health looks like in just a few countries:
Poverty And Mental Illness
People with mental illness often live in chronic poverty. Conversely, poverty can be a significant risk factor for poor physical and mental health. The relationship between poverty and mental illness is both straightforward and complex. Understanding this broader context is key to addressing poverty in order to promote mental health and support the recovery of persons with mental illness.
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Impoverished Neighborhoods Contribute To Development Of Psychoses
Our investigation revealed three specific factors that contributed to the probability of being diagnosed with psychosis-spectrum disorders in adulthood, even after accounting for parents own diagnoses. These were social behaviors with peers in childhood, neighborhood-level socioecological conditions in childhood, and changing socioecological contexts over maturation. Children in the 1970s who were raised in the most socioeconomically disadvantaged neighborhoods were at the greatest risk of being consistently diagnosed with either schizophrenia or bipolar disorder with psychosis by the time they were in middle adulthood. Further, those individuals who were diagnosed with either schizophrenia or bipolar disorder with psychosis also were likely to experience a worsening of neighborhood socioeconomic conditions as they matured from childhood into adulthood .
In addition, diagnoses of other psychosis-spectrum disorders were associated with both disadvantaged neighborhoods in childhood and worsening neighborhood conditions from childhood to adulthood, though these were moderated by childhood social behaviors. Specifically, those children who were seen by their peers at school as being both highly aggressive and highly socially withdrawn were more likely to be diagnosed with other psychosis-spectrum disorders, but only if they had been raised in more disadvantaged neighborhoods or if they experienced worsening neighborhood conditions as they became adults.
Reinvigorate Social Psychiatry And Influence Public Policy
The demise of social psychiatry in the UK and USA in recent decades has deflected focus away from the social causes and consequences of mental health problems at the very time that social inequalities have been increasing. Now is the time to renew social psychiatry at professional and academic levels. There is considerable scope to form alliances with other areas especially public mental health agencies and charities. Psychiatry as a profession should support those advocating for progressive public policies to reduce poverty and its impact. If we do not, then, as Phelan and colleagues outline, we will focus only on the intermediate causes of health inequalities, rather than the fundamental causes, and this will ensure that these inequalities persist and are reproduced over time.33 Activism with those who have consistently highlighted the links between poverty and mental health problems, such as The Equality Trust, may effect change among policy makers.
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Growing Up In Poverty Increases Risk Of Developing Psychosis
A persons risk for developing psychosis-spectrum disorders such as schizophrenia in adulthood is determined by multiple factors. With this in mind, we examined the risk for the development of such disorders in a two-generation, 30-year prospective longitudinal study of 3,905 urban families in Montréal, Canada. This study took place against a sociocultural backdrop of changing economic and social conditions. We found that individuals who were both highly aggressive and highly withdrawn were at greater risk for other psychosis-spectrum diagnoses when they experienced greater neighborhood disadvantage in childhood or worsening neighborhood conditions as they aged. Childhood neighborhood disadvantage predicted both schizophrenia and bipolar diagnoses, regardless of childhood social behavior. Our results suggest that policy interventions aimed at improving neighborhood conditions may help to decrease the prevalence of psychosis-spectrum diagnoses in the future.
Key Facts
- Environmental contexts contribute to individuals risk for developing psychosis-spectrum disorders in adulthood.
- Children growing up in impoverished urban neighborhoods are more likely to receive consistent diagnoses of schizophrenia and bipolar disorder as they age.
- Policy interventions to address the needs of families living in poverty may help to reduce the future prevalence of costly psychiatric diagnoses.
How Does Poverty Influence The Behaviour Of An Individual
In sum, poverty seems to influence behavioural patterns by shifting ones focus towards meeting immediate needs and threats. The stereotype of behavioural norms in low-income groups facilitating greater risk-taking and impulsivity at the cost of ambition and motivation is not supported by the research reviewed.
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Measuring Psychiatric Status And Socioecological Circumstances
Using data from the Concordia Longitudinal Research Projectinitiated in the inner-city neighborhoods of Montréal, Québec, in 1976we conducted an intergenerational, longitudinal study of nearly 4,000 families monitored over 30 years. The subjects of the study included two generations of each family, the parents and the children. Members of the parent generation in the Concordia Project were primarily born between the 1930s and 1950s and their children were born between 1965 and 1971.
Combining records for these two generations with numerically coded health records provided by Québecs health ministry, we assigned five mutually exclusive categories of adult psychiatric status to members of both generations. These were Schizophrenia Bipolar diagnosis with psychosis Other psychosis-spectrum diagnosis Non-psychotic diagnoses and No diagnosis. We also used census tract data from 1986 and 2006 to assess neighborhood socioeconomic disadvantage based on income, education, employment, and father presence. Finally, we measured social-emotional characteristics in childhood for the children using peer reports of aggression, social withdrawal, and likeability provided by 4,100 of their classmates.
The Link Between Mental Illness And Poverty
For years, researchers have examined the relationship between poverty and mental health problems. For example, the Substance Abuse and Mental Health Services Administration is a federal agency that often analyzes many aspects of mental illness, addiction and co-occurring disorders, which involves both diseases.
In 2016, SAMHSA released a report about the association between mental health disorders and poverty. The report indicated that 9.8 million adults in the United States had a serious mental illness in 2015. Nearly 25 percent of these individuals were living below the poverty line.
A serious mental illness is a mental, behavioral or emotional disorder that significantly interferes with or limits a major life activity. Major depression, bipolar disorder and schizophrenia are examples of serious mental illnesses.
According to a SAMHSA report, adults ages 26 or older were more likely than those at or above the federal poverty line to experience a serious mental illness. Living near or below the poverty line increases the risk of significant mental health problems.
According to a Gallup poll, depression disproportionately affects people in poverty. The 2011 poll found that about 31 percent of individuals who are living in poverty and 15.8 percent of those not in poverty reported having been diagnosed with depression.
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What Does Data Tell Us About Poverty And Mental Health
- In Wales, 20% of adults in the most deprived areas report being treated for a mental health condition, compared to 8% in the least deprived.
- Children from the poorest 20% of households are four times as likely to have serious mental health difficulties by the age of 11 as those from the wealthiest 20%.
- Suicide rates are two to three times higher in the most deprived neighbourhoods compared to the most affluent.
- The more debt people have, the more likely they are to have a mental health problem. One in four people experiencing a mental health problem is in problem debt. People with mental health problems are three times more likely to be in financial difficulty.
- Good quality employment is one of the most strongly-evidenced determinants of mental health. In January 2021, 43% of unemployed people reported poor mental health .
Absolute Poverty In High
Rates of poverty in the Organization for Economic Co-operation and Development countries vary between 4.9% in Iceland as the lowest rate up to 19.9% in Costa Rica, whereby the highest poverty rate among high-income countries can be found in the United States with 17.8% . One subgroup affected by poverty in high-income countries are people exposed to homelessness. With an estimation of 1.9 million persons without a home, and increasing numbers in countries like the United States, United Kingdom and Germany , several research and policy initiatives focus on the interrelation between mental health and living conditions in poverty.
Persons with debts and substantial loans represent another group affected by poverty in high-income countries. In Western countries like Germany, 8.6% of the general population have debts that cannot be cleared because of insufficient income and assets . Again, persons with mental health issues are disproportionately affected by debt. In a study with 486 psychiatric patients, 55.1% had outstanding debts, loans, or unpaid bills, of which more than a third reported debts between 10.000 and 99.999e . Here, binary regression analysis identified younger age and substance use disorders as being significantly associated with outstanding debts .
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