Which Came First, Mental Illness Or Poverty?

Growing up, I was taught in my life that poor people were lazy and they relied on the government to get them through life. As I became educated I learned that poverty is complex and people find themselves in these situations because of terrible life events such as sickness, death, and being unable to afford their homes due to price increases. Now as someone who tries her best to help people living in poverty-usually by donating to charities- I always thought mental illness was one precursor to poverty. By reading news and studies after scourging the internet, I’ve learned that poverty can be a precursor to mental illness.

There has been groundbreaking research that shows that poverty inflicts such a massive cognitive load on individuals that they have very little mental bandwidth to do many things that can lift them out of poverty such as go to night school, search for a new job, or even remember to pay bills on time. This research was concluded through a series of experiments that were conducted by researchers at Princeton, Harvard, and the University of Warwick. In these experiments, the researchers primed low-income people to think about financial problems through series of cognitive tests. The low-income people performed poorly on the tests and their mental load was akin to losing an entire night’s sleep. A similar metaphor is that living in poverty imposes a mental burden that is similar to losing 13 IQ points, or the cognitive difference between an alcoholic and normal adults.

This conclusion is critical because it undermines the belief that poor people, through their own weakness, are responsible for their own poverty or with enough effort they are able to pull themselves out of poverty. The research shows that the reality of poverty is it’s super difficult to accomplish fundamental life skills. According to one off the authors of the study, being poor means, “coping with not just a shortfall of money, but also with a concurrent shortfall of cognitive resources.”

In a 2005 study, researcher Chris Hudson looked at health records of 34,000 patients who had been hospitalized at least twice for mental illness over a period of 7 years. He looked at whether or not the patients “drifted down” to less affluent ZIP codes following their first hospitalization.” He found that poverty—acting through economic stressors such as unemployment and lack of affordable housing— is more likely to precede mental illness except for patients with Schizophrenia. Hudson’s data says that “poverty impacts mental illness both directly and indirectly.”

On an international level, researchers Johannes Haushofer and Jeremy Shapiro found in their study that when families in Kenya were given cash grants averaging $700 (nearly twice the amount typically spent per person per year), they reported higher levels of life satisfaction and lower levels of depression than they did before they got money, which they could spend on anything. The larger the cash transfer, the bigger  mental boost. It did not matter whether the money came in monthly installments or all at once.

In a study published by Swedish researchers, David Cesarini, Erik Lindqvist, Robert Ostling, and Bjorn Wallace, they disproved the belief that winning the lottery destroys lives as people make bad decisions about how to use money. The researchers found that lottery winners used fewer anti-anxiety medications and sleeping pills after collecting their payout, implying that they became happier.

There are a variety of ways that poverty is an antecedent to mental illness. These ways include:

        • Stress over prolonged periods of time: In 2011, information published by the Fragile Families and Child Wellbeing Study showed that generalized anxiety disorder, which is characterized by anxiety over non-specific things, was most widespread in the poorest individuals of a particular sample population. Mothers, especially in developing countries, were troubled about their child’s safety, nutrition, and physical and social development. Regardless of their anxiety, they were compelled to make ends meet and continue to provide for their families by cooking food, cleaning the house, and ensure that utility bills were made on time. Other studies have found higher levels of the stress hormone cortisol in people living with poverty. In a 2009 study, young children in Mexican households that received cash grants had lower cortisol levels compared to kids from families that did not get extra money. However, there are other studies that have failed to find any changes in cortisol levels.
        • Improvised Living Conditions: Living in low SES often results in an inability to afford basic necessities such as food, clothing, and shelter. It can culminate in poor living conditions and in some situations homelessness due to the inability to afford rent or mortgage expenses. These situations can cause stress and dispose individuals to mental health conditions such as depression.
        • Limited Access to Health Care Services: People living in poverty typically have lacking financial resources that prevent them to accessing affordable health care services. This can prevent them from seeking help early and can result in the progression of their mental health condition.
        • The Attention Towards Children’s Needs are Decreased: Parents living in poverty stricken households are likely to be preoccupied with several concerns such as debt, stress from work, and even the relationship with each other. These worries may lead away attention from the growth and development of their children, leading to detrimental effects on mental health. It is estimated that depression has a predominance of 0.4 to 2 percent of children ages 6 to 12 years.

There are potential solutions to prevent mental illness from affecting people living in poverty. They include:

        • Improvised situations can be addressed through aid provided by developed countries and increased public disbursement on necessary facilities such as schools, hospitals, and transportation.
        • The government can also play a role in supporting households by providing subsidies and grants for education and discounts for healthcare.
        • People living in poverty can be encouraged to access healthcare services through subsidies and increased distribution of local clinics, which make it possible to receive care without traveling long distances. It is also important to have regular monitoring and sampling of mental illness in impoverished areas.
        • Access to services that help women in proper care and upbringing of children can focus on effects of excessive stress on children. Also, parenting programs and reliable child care services can help children living in poor conditions receive the care that they need.

I will preface that these are not cure-all solutions. Poverty and mental illness are ever-changing issues that are dependent on the environment, the individual, and the culture. In my opinion, mental illness and poverty have to crusade together and not separately since both issues strongly affect each other.

Sources:

CityLab

NPR

Psych Central

The Borgen Project

By Jim Fischer (Flickr: Homeless in Sugamo 2) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons