The Impact of Poverty on Mental Health : Exploring the Connection

1. Introduction

1. Definition of Poverty

   Poverty is defined as the lack of sufficient income to offer the necessities of life, consistent with society’s norms. ⁽¹⁾ In the case of inadequate income, acquiring the essentials of life like food, employment, housing, and education, is impossible.

   The depth of poverty could be measured by how far people and households fall below the poverty line and also by the number of years they remain poor. Some people, like those with any sort of disability, are at more risk than other people in chronic poverty. ⁽²⁾ Individuals with any sort of mental illness are at risk of suffering from poverty.

2. Definition of Mental Health

   Mental health is highly essential at every stage of life and includes our emotional, psychological, and social well-being. It affects how we feel, think, and act. Our mental health also helps in determining how well we can handle stress, and make appropriate choices in life. Mental health can affect relationships, physical health, and our daily lives. So, taking care of mental health can preserve one’s ability to enjoy life.

   The WHO states that mental health is more than merely the absence of mental disabilities or mental disorders. Optimal mental health is about managing active conditions and also looking after ongoing wellness.

   More than 26 million individuals worldwide are diagnosed with serious cases of mental illness, with psychotic disorders ranking sixth among women and fifth among men as a leading cause of years lived with disability. ⁽³⁾

3. Importance of Exploring the Connection Between Poverty and Mental Health

   It should be noted that there is a connection between poverty and mental health. Individuals with mental illness usually live in chronic poverty. Alternatively, poverty can be a crucial risk factor for poor mental and physical health. To promote mental health and support the affected persons to recover from mental illness, one must understand the relationship between poverty and mental illness and then address poverty.

   Poverty in children and adults can lead to poor mental health through various social stigmas, stresses, and trauma. Equally, mental health issues can cause loss of employment or under-employment and poverty.

2. The Impact of Poverty on Mental Health

   Poverty in adulthood is connected with depressive disorders, psychological distress, anxiety disorders, and suicide. Poverty can affect mental health significantly. Let us read further to know more about the impact of poverty on mental health.

1. Stress and Anxiety

   Poverty can lead to growth in stress and also cause major physiologic responses, like high cortisol levels and high blood pressure issues. With prolonged exposure to poverty, one can ultimately suffer from long-term physical and mental health consequences. People with low incomes or incomes below the poverty level usually suffer from severe psychological distress.

   Certain studies have found that there are higher levels of cortisol or stress hormones in the case of people living in poverty. It was found from a study from 2009 that in Mexican households that received cash grants, young children had lower levels of cortisol compared to kids from families that did not receive any extra money. ⁽⁴⁾ However, other studies have failed to find any changes in this stress hormone cortisol.

   Poverty leads to stressors like insecurity and uncertainty bout housing, food, and income. These stressors could result in an increased risk of mental health issues.

2. Depression

   Economic inequality can affect mental health independently of poverty. Both within countries including the United States and internationally, area-level income inequality has been inked with various mental health outcomes including more cases of depression, drug overdose deaths, incidences of schizophrenia, juvenile homicides, child mental health issues, and adverse child educational outcomes. ^{(5, 6, 7, 8)}

   A review from 2010 that included 115 studies found that nearly 80% of the studies have shown that poverty is associated with higher rates of mental illness. ⁽⁹⁾ Those studies also found that mental illnesses were more severe and lasted longer among people living in poverty. There is also growing evidence that depression levels are higher in poorer countries when compared with the wealthier ones.

   Depression affects people in poverty significantly. As per a Gallup poll, depression disproportionately affects individuals in poverty. ⁽¹⁰⁾ It was found from2011 poll that around 31% of people who are living in poverty and 15.8% of those who are not in poverty have reported being diagnosed with depression.

3. Substance Abuse

   Another significant impact of poverty on mental health is that it increases the chance of substance abuse. Mental health problems and poverty when combined can increase the risk of developing addiction or substance abuse, which needs treatment.

   Actually, poverty increases feelings of hopelessness and makes people feel powerless over their future, which can create a vulnerability to substance abuse.

   It has been found that drug use is more prevalent in poor communities when compared with wealthier ones. According to the Centers for Disease Control and Prevention, it has been stated that the use of heroin is nearly three times more common among families with an annual household income below $20,000 when compared with those families making an annual income of $50,000 or more every year. ⁽¹¹⁾

4. Post-Traumatic Stress Disorder (PTSD)

   Post-traumatic stress disorder or PTSD is an extremely severe health condition in itself. Researchers have mentioned that socioeconomic status can be associated with a majority of anxiety disorders which can later manifest into post-traumatic stress disorder. ⁽¹²⁾ Financial woes, food insecurity, housing instability, and living in vulnerable conditions can wear on a person’s psyche, and habitually living with distressed and depleted resources can induce traumatic memories and lead to serious cases of PTSD. It can be said that when someone’s living condition or situation is uncertain and unstable, there is a greater risk of developing post-traumatic stress disorder.

5. Suicide

   It has been found in recent years that suicide rates are the highest among the poorest individuals. ⁽¹³⁾ This has been found that the children of people on welfare are twice as likely to die by suicide. It is shocking to know that homeless people kill themselves about ten times as often as those with housing. ⁽¹⁴⁾

   Poor individuals are more vulnerable to suicide since the strain of poverty increases one’s chance of developing a mental illness. People who have low socioeconomic status are likely to suffer from mental illnesses like depression, schizophrenia, and bipolar disorders. Researchers have found that suicide rates are rising along with increasing unemployment.

3. The Impact of Mental Illness on Poverty

   Without appropriate treatment available for poor people with mental illness, they start suffering in silence and slowly fall back from their jobs, and families. Loss of employment results in a lack of income, thus resulting in poverty.

   Let us take a deeper look at the various impacts of the mental illness of poverty.

1. Reduced Educational And Employment Opportunities

   Mental illness can result in poverty, which can also limit access to educational and employment opportunities, which can further contribute to loss of income and ultimately effecting poverty.

   Residents of impoverished communities generally have reduced access to various resources that are required for supporting a healthy quality of life, like healthy foods, stable housing, and safe neighborhoods. ^{(15, 16, 17)}

2. Increased Healthcare Costs

   Adults living in poverty along with children are at a higher risk of adverse health conditions from chronic stress, obesity, and substance abuse.

   Improper environment, unmet social needs, and barriers to accessing healthcare can contribute to worse health problems for individuals with reduced incomes. (18, 19) For instance, individuals with limited finances might have more difficulty obtaining health insurance or paying healthcare expenses. ⁽²⁰⁾

3. Homelessness and Housing Insecurity

   There is a connection between housing instability and mental and physical health outcomes for many years. Many people live below the poverty line in the U.S. and look for a roof over their heads, food on their tables, and means to obtain mental and physical healthcare.

   A study conducted by researchers at Boston Medical Center or BMC has reported that you do not have to be homeless to experience mental and physical health outcomes from housing insecurity. ⁽²¹⁾ The study included more than 22, 000 families and interviewed them about their housing situations like being late for rent, having a homeless child, and so on. These families experienced extremely poor health conditions and many mothers even lived with ongoing symptoms of depression.

4. Intergenerational Poverty

   Intergenerational poverty is the continuous cycle in which poverty is passed from one generation to the next. This indicates that impoverished parents have impoverished children. This relentless cycle of poverty occurs due to the lack of resources that poor people receive, such as inadequate education and healthcare.

4. The Intersectionality of Poverty and Mental Health

   Intersectionality is a way of understanding the impact and experiences of intersecting and overlapping identities. This concept was developed by Kimberle Willaims Crenshaw in 1989. People surviving with mental health problems might be members of several groups that experience stigma which can impact their quality of life and also slow down their treatment.

   It should be noted that identities and personal experiences differ within cultural or social groups. Individuals with intersecting or overlapping identities tend to face additional harassment and discrimination. Approaching proper mental health treatment could be one way that relates to addressing this issue.

1. Race and Ethnicity

   Historically several racial and ethnic minorities have faced systemic discrimination related to their mental health, or mental illnesses. Racism and overt discrimination are two chronic stressors that are linked with stress, depression, and mental illnesses. Individuals who experience discrimination across various systems, experience increased negative mental health outcomes.

   A high level of self-value and strong ethnic/racial identity can protect against the mental health impacts of discrimination.

2. Gender

   Gender inequity can also result in poor mental health outcomes, which can be due to violence, abuse, discrimination, and poor or unsafe working conditions. Gender bias can lead to mental illnesses. Negative social attitudes to an individual’s gender identity can cause chronic stress.

3. Age

   Family poverty predicts higher rates of anxiety and depression in adolescents and adults. Increased frequency of a child’s exposure to poverty is a consistent predictor of adolescent and young adult depression and anxiety. A child who experiences poverty for a long time has an increased chance of suffering from poor mental health.

   The poverty experienced in early childhood can affect cognitive and other developmental and health outcomes. However, little is known, about whether there could be critical periods during childhood when exposure to poverty might have irreversible or major consequences. ⁽²²⁾

4. Sexual Orientation

   People who are identified as LGBT2Q+ have more chances to suffer from mental health issues. Lack of acceptance and perceived differences put long-lasting effects on their mental health and well-being. Discrimination and violence experienced by LGBT2Q+ people result in chronic stress, isolation, anxiety, and community violence. Trauma can also result in addiction, mental illnesses, and suicidality. Connecting with a supportive community and peer group could be one of the protective measures against mental illnesses in people with sexual orientation.

5. Disability

   Restriction or disadvantage of an individual’s ability to take part in specific activities or to interact with society or people around them could be considered a disability of a person.

   Disabilities can exclude people from participating in different social activities. Again, the social, emotional, and financial impacts of disability on a person can create chronic strain and result in adverse mental health impacts.

5. Policy Implications and Interventions

1. Policy Changes To Reduce Poverty and Improve Mental Health

   It is now time to renew social psychiatry at academic as well as professional levels. Psychiatry as a profession must support people advocating for progressive public policies for reducing poverty and its impact on mental health illnesses.

   People who are eligible to work but cannot work because of a lack of support for their children can get benefits from childcare and paid family leaves. Affordable and safe childcare facilities can keep working communities connected to work and reduce poverty. In addition, good employment opportunities can also help keep people away from poverty.

   Additionally, some policies and their implications can be greatly beneficial.

   The Child Tax Credit: The Child Tax credit is one of the largest federal investments in children that can help end child poverty and develop the middle class.

   Mental Health Policy: This policy is a specific written document of the Government or Ministry of Health and it comprises the goals to improve the mental health situation of the country.

2. Mental Health Treatment Options For People Living In Poverty

   Poor knowledge about symptoms of mental health issues, stigma, myths related to it, lack of available treatments, and potential benefits of seeking treatment, are some of the major causes for the high treatment gap.

   One should take time to understand various health insurance and also affordable treatment options available in the U.S. and seek the best possible treatmet plan for their mental illnesses. Implementing cognitive-behavioral therapy or CBT in low-income communities with mental illnesses could be effective. Cognitive behavioral therapy can help people address depression, anxiety, and other mental health problems.

3. Community-Based Programs and Support Services

   Support groups and self-help groups can help you come out of your mental health condition. The support and resources that you receive from these support services or community-based programs will surely be of great help. These support groups also help addresses your feelings of isolation and give chance to build a healthy and happy community.

4. Importance Of Addressing Stigma And Discrimination

   It is highly essential to address stigma and discrimination. Stigma and discriminations are barriers faced by poor people or those with low incomes. People living with depression, anxiety, and other mental disorders in such low-income communities not only experience the stigma of their mental health but also that of living in poverty, which can eventually lead to self-discrimination, self-doubt, and a lack of self-confidence.

6. Conclusion

   Mental health and poverty are interconnected. Though people from high society and high income meet with mental health issues, chances of overcoming the mental illnesses and getting appropriate treatment are quite low in people from low-income communities. However, having appropriate policies, healthcare insurance, and services that could work for the benefits of mentally ill people from poor communities, will help to get rid of mental health issues and also poverty. We should try to build a future that is free from poverty and mental illness.

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