Social Influences and Mental Health

Millions of individuals will be affected by poor mental health at some time during their lives, and though anyone can experience these problems, there are some people from certain backgrounds and social situations who are at a significantly greater risk. Despite welcome new attitudes in society which are far more accepting of mental health issues, many sufferer's still find they have to face barriers in society such as employment, health care, family, support and community which those of us in good mental health may take for granted.

Social exclusion such as this can have long lasting and reverberating affects on certain individuals and groups in society, unfortunately often marking the start of a downward trend into poor health, unemployment, debt and family breakdowns.

This fact-sheet brings together statistics from various studies and health resources in order to give you the bigger picture of how social and economic factors can act as contributing factors in poor mental health, and vice versa.

Employment and mental health

Whilst public awareness, understanding and tolerance of mental health conditions has grown considerably in the past few years, huge barriers still remain for individuals with mental health concerns who are seeking employment. Employment is an important factor when it comes to mental distress because some illnesses disrupt the sufferer's normal way of life. If their problem is seriously affecting their work then it is likely they will not be able to continue in their role, or may have to limit the type of work they do. In some situations, individuals suffering from a form of distress, such as anxiety believe their working environment has triggered their abnormal feelings.

Mental illness is a huge problem in the UK workforce, with stress related problems such as anxiety and depression affecting one in six at any one time. There is various evidence which suggests that many people suffering from mental health conditions actually want to work. However, a study commissioned by Shaw Trust (a charity which helps disadvantaged people to prepare for work and find jobs), found that 40 per cent of employers still see mental health problems in workers as a significant risk1.

The same study also found that 42 per cent of employers underestimate the true prevalence of ill mental health in their workplace, and though 90 per cent of employers say they would feel comfortable discussing mental health problems with an employee and 73 per cent said they would be happy to discuss mental health issues with a job applicant, many employees and potential employees still feel that it would be perceived in a negative way and thus choose not to disclose their conditions2.

Mental illness costs employers an estimated £26 billion every year, which amounts to around £1,035 for each individual employee in the UK workforce. However, despite both an increased awareness of mental health conditions in the workplace, and their cost to businesses, 72 per cent of companies still have no formal policy on mental health support. Research has indicated that if businesses begun to take simple steps such as improving the management of mental health within the workplace, they could reduce the above costs by up to 30 per cent, saving the economy an estimated £8 billion a year1.

According to figures from the 2004 Mental Health and Social Exclusion Unit Report, only 24 per cent of adults suffering from long-term mental health problems are in work, representing the lowest rate of employment for any of the primary groups of disabled people. Furthermore, in the same study it was found that individuals suffering from mental health concerns stood double the risk of losing their job than those without a condition3.

The report also cited various studies which suggested that extended periods of unemployment are linked to the deterioration of mental health. In contrast, having a job can result in the reduction of symptoms, less admissions to hospital and a reduction in the number of services used. Unemployment is also linked to a heightened risk of suicide, general health problems and premature death3.

Mental health charity, Centre for Mental Health have published a report detailing recommendations which would both save money and help those with mental health concerns to become employed and stay employed. Recommendations include awareness training for managers to help them understand and respond to mental health problems in good time, improved access to help for employees so that they can continue working whilst receiving support, and rehabilitation for those who do need time off work.

Caring

Each year an estimated 2 million individuals will become carers. A carer is an individual who provides support to a family member or friend, often in ill-health, who would not be able to cope on their own. This could mean caring for a parent or a spouse who is either frail, mentally ill or disabled and in many cases a carer will have to leave their job in order to care full time4.

Only in recent years have the government begun to recognise how important it is to provide carers with continuing support on both an emotional and financial level, and though many rules relating to care benefits are outdated, carers do have more rights now than ever before. The Flexible Working Regulations 2007 and the Carers Equal Opportunities Act 2004 require more flexible working hours from employers and increased involvement from local authorities to ensure that carers know what they are entitled to and are able to continue the social activities they had before they took on their caring role.

Leaving a paid job to become a carer unfortunately will often mark the beginning of a downward spiral into poverty, social exclusion and mental illness, with many finding that their carers allowance is not enough to get by. Not having a job and caring full time also means that there is little time and opportunity to socialise, and the nature of caring and all of the combined factors can lead to the onset of mental illness.

A 2011 study from Carers Scotland “Sick, tired and caring: the impact of unpaid caring on health and long term conditions” found that unpaid carers have twice the prevalence of long term illness and disability than the rest of the Scottish population5. Additional significant findings detailed in the report include the following:

  • 96 per cent of participants said that caring had negatively affected their health.
  • 25 per cent of participants rated their health as either poor or very poor.
  • 57 per cent participants had a long term illness of disability.
  • 68 per cent of participants experienced physical issues such as hip, back, neck and joint pain, as well as a third suffering from arthritis, osteoarthritis or osteoporosis.
  • 86 per cent of participants suffered from stress, anxiety and depression.
  • 34 per cent of participants suffered from exhaustion.
  • 54 per cent of participants said they felt isolated and were unable socialise with family and friends.

The financial impact of caring

As mentioned above, caring can have a hugely detrimental affect on an individuals financial stability. Figures from Carers UK suggest that one in every five carers have to give up work in order to fulfil their responsibilities, losing an average of £11,000 income4.

Furthermore, carers are provided with little financial support from the government, with the main source of benefits - Carer's Allowance currently just £53 per week despite the fact that full time NHS care for a patient would cost far more. Outdated rules about who is able to receive benefits also mean that those who still are able to work are deterred from doing so and many carers who are either over 65 or sick themselves miss out on carers' benefits altogether.

Caring for someone with a mental illness

A 2002 study revealed that there are up to one and a half million individuals in Great Britain who care for a friend or relative with a mental health condition or some form of dementia6.

Looking after someone who is suffering from a mental illness can be an extremely challenging and stressful experience. Each individual who finds themselves affected by a mental illness will experience a different level of severity, and where some mild issues can be helped with support and understanding from a carer, more severe mental illnesses such as schizophrenia and bipolar disorder will result in the carer being faced with more difficult problems.

Evidence suggests that individuals suffering from a mental illness cope far better when they have a family member or a friend looking after them than when they are on their own.

Young carers

Young carer is the term used to describe children and young people under 21, who have taken on the responsibility of caring for someone in their family. This could include taking care of a family member with a disability, a long term illness, poor mental health or an addict. Unfortunately, a lack of awareness and inadequate support services mean that many children and young people have no alternative but to take on practical and emotional caring responsibilities which are more appropriate for adults.

According to figures from the 2001 census, there are an estimated 175,000 young carers in the UK, with 13,000 caring for in excess of 50 hours each week. The Princess Royal Trust for Carers consider the actual number to be far higher than this due to the census not taking into consideration alcohol and drug related problems which many young carers may attempt to mask. In addition, the National Association for Children of Alcoholics estimates that there are 920,000 children living with parents for whom alcoholism is a problem, and a 2004 national survey conducted by Loughborough University Young Carer Research Group found that young carers looking after someone who suffered from drug or alcohol misuse only accounted for 29 per cent of those receiving support7.

There is mounting evidence that young carers are negatively affected by their caring roles, with studies showing that they are more likely than other children to miss school, fall asleep during lessons, be the target of bullying from peers and face an increased risk of isolation.

Whilst caring for and supporting a loved one is important, it is also crucial that you take the time to look after and consider your own physical and mental wellbeing. If you begin to feel depressed and anxious or are exhibiting any other symptoms which are cause for concern then it is essential you seek help. Visiting your GP should always be your first port of call, and they will be able to discuss with you the impact your role as carer is having on your mental health. Your GP will be able to give you professional support and advice about the next steps and may either suggest or refer you to a counsellor or another form of talk therapy where you will be able to outlet your feelings.

Housing, homelessness and mental health

The link between poverty and health is well documented, as is the link between health and housing, with increasing evidence suggesting that improved housing would actually mean improved health for many8.

Homelessness has an equally if not worse affect on both physical and mental wellbeing, with homeless people finding it extremely difficult to register themselves with a GP which means they are unlikely to receive help for either physical ailments or mental health issues9,10. According to 2004 statistics from the Office of the Deputy Prime Minister as cited by Mind, between 30 and 40 per cent of individuals who sleep rough have mental health problems, with other studies suggesting that as many as 70 per cent of homeless people suffer from some form of mental illness.

References

1Centre for Mental Health (n.d.) Mental Health at Work: Developing the Business Case. Available: http://www.centreformentalhealth.org.uk/publications/MH_at_work.aspx

2Trajectory (2010) Mental Health Remains The Last Workplace Taboo!, Commissioned by Shaw Trust. Available: http://www.tacklementalhealth.org.uk/

3Office of the Deputy Prime Minister (2004) Mental Health and Social Exclusion: Social Exclusion Unit Report. Available: http://www.google.com/search?ie=UTF-8&oe=UTF-8&sourceid=navclient&gfns=1&q=Social+Exclusion+Unit+%282004%29%2C+Mental+Health+and+Social+Exclusion%2C+London%3A+Office+of+the+Deputy+Prime+Minister.

4Carers UK (n.d.) Our Campaigns. Available: http://www.carersuk.org/Newsandcampaigns/Ourcampaigns

5Carers Scotland (2011) Sick, tired and caring: the impact of unpaid caring on health and long term conditions. Available: http://lx.iriss.org.uk/content/sick-tired-and-caring-impact-unpaid-caring-health-and-long-term-conditions

6National Coordinating Centre for the Service Delivery and Organisation (NCCSDO) (2002) Services to support carers of people with mental health problems. Available: www.sdo.nihr.ac.uk/files/adhoc/15-briefing-paper.pdf

7The Princess Royal Trust (n.d.) Press release: Vulnerable and hidden Young Carers targeted with new £1million Fund. Available:http://www.carers.org/press-release/vulnerable-and-hidden-young-carers-targeted-new-%C2%A31million-fund

8Schroeder, D., Wolff, C. and Young, M. (2001) Effect of improved housing on illness in children under 5 years old in northern Malawi: cross sectional study, British Medical Journal.

9Office of the Deputy Prime Minister (2004) Policy Briefing 7: Health Needs of Homeless People.

10Hatloy, I. (2007) The social context of mental distress, Mind. Available: http://www.mind.org.uk/help/social_factors/statistics_6_the_social_context_of_mental_distress