POVERTY AND MENTAL ILLNESS

Poverty and Mental Illness

Poverty and Mental Illness

Introduction

For decades, researchers have known that poverty and mental illness are correlated; the lower a person's socioeconomic status, the greater his or her chances are of having some sort of mental disorder. Yet determining if one comes first - if being poor renders a person more susceptible to mental illness, or if mental illness pulls a person into poverty - is decidedly difficult and the relationship between poverty and mental health has long been assumed to be interactive.

Poverty and Mental Illness

Yet a recently published large-scale, seven-year study suggests that poverty, acting through economic stressors such as unemployment and lack of affordable housing, is more likely to precede mental illness than the reverse. Christopher G. Hudson, Ph.D., chairperson of the School of Social Work at Salem State College, examined the records of more than 34,000 patients who had been hospitalized because of mental illness at least twice between 1994 and 2000. He looked at whether or not these patients had "drifted down" to less affluent ZIP codes following their first hospitalization.

Except for patients with schizophrenia, though, Hudson found little evidence of this downward drift. Hudson says his data suggests that poverty impacts mental illness "both directly and indirectly."

"Much of the impact comes through economic conditions such as housing and unemployment," he says. Other hypotheses Hudson tested, including the "downward drift" and the idea that lack of family support acts as a mediator between poverty and mental illness, received little support in his data.

Hudson's study follows a long line of research into the poverty-mental illness link that has been conducted since the late 1930s. These studies have repeatedly found higher rates of mental illness in low-income communities. Hudson's data shows mental illness to be three times as prevalent in low-income communities as in higher income ones; other studies have shown the rate to be anywhere from two to nine times higher in poor communities. Research into causes of mental illness began much later; levels of fatalism among poor people, levels of family and community support and unemployment were all examined as possible factors.

The relationship is still regarded by mental health professionals as a complex one. Elizabeth Childs, M.D., commissioner of the Massachusetts Department of Mental Health (DMH), says while it is not surprising that Hudson's study shows a correlation between serious mental illness and low socio-economic status, she does not infer that poverty leads to mental illness. "Poverty presents risk factors that may exacerbate mental illness," she says, and "can impede access to services that are necessary for early intervention and treatment. The evidence is increasingly clear that there are biological roots to serious mental illness, and as with many other medical illnesses, environmental factors, such as socio-economic status, can play a major role in the course of the disease," she says.

Kelly Anthony, Ph.D., a visiting assistant professor of social psychology at Wesleyan University who has researched poverty and homelessness, says that particularly in the United States, "relative poverty" - ...