While some may say that depression and anxiety are a growing middle class problem, the science tells us otherwise. The impact of deprivation on mental health is being increasingly researched and studies have found that mental and physical health tend to follow a ‘social gradient’. This means that the lower a person’s social and economic position, the poorer his or her health tends to be.
“There’s a report on mental health and poverty from the World Health Organisation and one of the key messages is that a two-way relationship exists between mental disorders and socioeconomic status," says Associate Professor kylie valentine*, the deputy director of the Social Policy Research Centre. "Mental disorders lead to reduced income and employment, which entrenches poverty and in turn increases the risk of mental disorder."
“It seems to be a very complex set of factors at play with mental illness and poverty,” adds Associate Professor Lucy Burns, a senior lecturer within the National Drug and Alcohol Research Centre. “It’s not necessarily linear. There are genetic factors and some mental health problems may be triggered by traumatic experiences that may then place a person at risk of being homeless.”
Mental disorders lead to reduced income and employment, which entrenches poverty and in turn increases the risk of mental disorder.
Burns has conducted studies looking at the impact of providing housing and support services to people who have been long term homeless. She says she has seen a shift occurring within support services to try and secure housing for an individual and then ensure other services wrap around that person to help. “Traditionally services would have needed someone to have their drug and alcohol problems sorted before they could help [with housing], but now we recognise that shelter is the first basic need,” Burns says. “Everything can build on that.”
Housing, income, education, social isolation and disability have all been identified as contributing factors to health inequalities. “It’s estimated up to 50 per cent of our health outcomes are determined by socio-economic factors,” confirms Valentine. Indeed, having a low socio-economic status is usually associated with high psychiatric morbidity, including depression, and mental health has been consistently linked with factors related to material deprivation and social inequality. And poverty has also been associated with reducing cognitive function as it consumes mental resources, leaving less for other tasks.
Housing, income, education, social isolation and disability have all been identified as contributing factors to health inequalities.
So why is this a big deal? Australia’s the lucky country, right?
Well, maybe not for everyone. Despite our relative wealth, Australia’s poverty rate is above the OECD average, with 13.3 per cent of the Australian population (that’s 2.99 million people) living below the poverty line in 2013-14. Over 731,000 of those people were children.
It’s commonly thought that diet, language exposure, family situation or antenatal issues impact the growth of children’s brains, however research has found that poverty has a much bigger influence on children than we give it credit for. Systematic reviews of the literature have also found that disadvantage begins at birth, is intergenerational and that children from poorer socioeconomic backgrounds are at greater risk of mental illness than those from more affluent circumstances.
Although the science isn’t particularly uplifting, Burns says hope is not lost. “There is a system that really helps people,” she says. “We lose people all the time to the system but if they are followed up we can prevent acute health issues that are associated with mental illness. The earlier people can get assistance the better. Early intervention is the key.”
Note: *intentional lower case spelling of name.
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All six episodes of Struggle Street series two are available to view on SBS On Demand.
Struggle Street series two is produced by KEO Films with funding support from Screen Australia and Film Victoria.