The intersection and difference: Mental health and poverty

A couple of weeks ago, I was at home watching the news, when a particular report by the BBC caught my attention. The report explored a very pressing issue gnawing at the fabric of UK society – the distressing rise in mental health issues, spurred by the relentless surge in the cost of living and the backdrop of an NHS service that is struggling to support the growing and complex needs of the nation.

This report emphasised the urgent requirement for a long-term strategy to combat the situation. It poignantly recounted the personal struggle of a young man, initially grappling with anxiety during his school years, who found himself admitted to the hospital for extended periods. Thanks to the intervention and support from his council, he was provided with accommodation to help rebuild his life and strive for stability.

The report also shed light on another disheartening development – an increase in school absenteeism. It examined the cases of specific schools that had taken the initiative to step into the homes of families facing hardship, administering what was termed as 'intensive support.' This measure aimed to assist families in getting their children to school during times of familial distress, particularly due to mental health breakdowns or financial struggles resulting from the cost of living crisis and the fallout from the Covid pandemic.

Upon reflection, these reports left me bewildered and quite angry. The programme highlighted the interventions that had directly improved the living situation, and therefore mental health outcomes for these individuals, as well as showing that the correlation between poverty and mental health is undeniable. We know that living in impoverished conditions, devoid of hope, undoubtedly takes a toll on an individual's mental well-being. This is why addressing child poverty is imperative. The impact of being an impoverished child extends far beyond financial prospects – it permeates one's psychological framework and shapes their view of oneself and the world. It can seem a formidable challenge to escape such circumstances.

However, it is crucial to recognise that poverty and mental health, while closely linked, are distinct issues. What struck me most about the report is that while it stated the imperative is to create mental health services and devise strategies aimed at enhancing and supporting psychological well-being, it missed the acknowledgement that in situations of poverty, the role of mental health professionals, such as psychotherapists, psychiatrists, doctors, and social workers, is rendered significantly limited if we focus solely on the 'mental health' aspect and overlook the broader issue of lack of funds, food, housing, and more broadly, societal inequality itself.

Efforts aimed at bolstering mental health services cannot occur in isolation. We must tackle poverty at its root, addressing the socio-economic factors that perpetuate mental health issues. This holistic approach would intertwine mental health care with policies to mitigate poverty and uplift vulnerable communities. It is essential for true societal well-being, to provide immediate mental health support but also address systemic inequalities and advocate for policies that uplift individuals from poverty, fostering a society where mental well-being can truly flourish.

Esther Perell put it perfectly at the FT Weekend Festival in London last year. She talked about being ‘sensitive to pathologising individuals instead of understanding that our society may have some troubles’. She goes further in saying that the mental health crisis – while it does well to bring attention to our psychological well-being – also individualises the social problems we have, effectively allowing us (and those in power) to scapegoat the issue. She notes that many people living with anxiety are living in a state that is entirely appropriate, given the circumstances.

From my perspective, the BBC report did not go far enough in acknowledging this, in recognising that we have deep-rooted, societal inequality right now, something that a long-term NHS strategy cannot fix. We need to accept that our society has its issues. Hopefully, once we can be open and realistic about this, we can bring about the change that is needed and eventually get back to strategising the mental health of the nation in a way that will truly benefit us all, rather than constantly firefighting in an ongoing, unacknowledged crisis.

For patients and clients, it could perhaps bring comfort that we are not ‘unwell’ if we suffer from poor mental health during times of great, financial difficulty – that our reactions are understandable. And for those of us who are therapists, we might be able to work better, knowing the weight of society’s failings (and the expectation to fix it), is not loaded onto us.

References 

Patrice L. Engle, Maureen M. Black (2008), The Effect of Poverty on Child Development and Educational Outcomes, The New York Academy of Sciences, Available here:https://nyaspubs.onlinelibrary.wiley.com/doi/full/10.1196/annals.1425.023