There’s some truth to the widely held view that mental illness causes poverty. Mental illness can form a barrier that prevents people fully participating in the community.
Irene Verins, Mental Wellbeing Manager at VicHealth, says a mental illness may make someone unable to work or study, which has economic implications. “It could lead to an inability to pay the rent or the mortgage, or feed the kids and the family,” she says.
Less publicised is the effect poverty has on mental health, a link long recognised in academia. “Poverty can be both a determinant and a consequence of poor mental health,” write Vijaya Murali and Femi Oyebode in a 2004 article, ‘Poverty, social inequality and mental health’.
Socioeconomic disadvantage is clearly associated with poorer mental health, says Verins. “If you are lower on the social ladder, and if you are poorer, then you are more likely to experience poor health.”
“As the gap between rich and poor is getting greater, the potential negative impact on mental illness and mental health will also become greater."
Barriers to opportunities like work and education can lead to poor social connection, increased social isolation and a lack of attachment to communities, she says. “Unemployed people, people with low incomes, limited education, or unskilled occupations, those who are refugees or new arrival communities, Aboriginal and Torres Strait Islander peoples, and some people with a disability or from LGBTQI+ communities often experience poorer health and mental wellbeing than the rest.”
Part of the reason is social exclusion, an increasing problem due to rising levels of income inequality in industrialised societies like Australia. “As the gap between rich and poor is getting greater, the potential negative impact on mental illness and mental health will also become greater,” says Verins. “That's why we're really concerned about it.”
The stress of poverty
Life on or under the poverty line is inherently stressful. When you have to survive on a low income, it’s a struggle to pay the rent and put food on the table. An unexpected event – the car breaks down or a child gets sick – can quickly become a crisis. Poverty obstructs a person’s ability to work, study and live life as others would, says Verins, which creates stress that impacts on individuals and families.
It’s no wonder that this stress can have a negative effect on our mental health. Murali and Oyebode note that poverty-related stress is “causally related to depression” and associated with factors like exposure to social adversity and lack of resources to cope with difficulty that might contribute to the development of mood disorder.
People living in poverty are also more likely to experience unemployment, which Murali and Oyebode found increases the likelihood of drug dependence, phobia, psychosis, depression, anxiety and other psychiatric disorders.
Poverty has physiological ramifications too, says Verins. “It can also impact stress hormones, immune system, sleep patterns, and certainly puts us at greater risk of disease and injury.”
A 2012 study into the relationship between poverty and stress looked at the physical effects rainfall – or the lack of it – had on Kenyan farmers compared to urban workers. The study’s authors found that “negative events lead to increases in worries and the stress hormone cortisol in poor people,” noting that stress is an established precursor to depression.
Another issue is problems accessing services – “because you either can't afford to, or you can't drive to the service, or you can't get there, or you can't pay for it,” says Verins. “Mental disorders like stress, anxiety, and depression are very normal conditions that most people experience at some point in their lifetime. What makes those more chronic and longer term is when they're not treated.
“It can also impact stress hormones, immune system, sleep patterns, and certainly puts us at greater risk of disease and injury.”
“If you can't access services because of a range of barriers, then it's highly likely that you'll have ongoing and long term poor mental health or mental illness. What that will mean is that you then can't access or stay in appropriate employment and earn a wage,” she says. “The flow on effect of lack of access to services is really important.”
In its efforts to reduce the incidence of mental illness in the community, VicHealth runs programs designed to build resilience, which Verins describes as “being able to cope with bounce back and move on and adapt to change, or adversity, or challenge.”
Another important preventative measure is social connection, which could mean having just one important person in your life. “We know that above and beyond many issues, keeping social connections are fundamental, because they act as a buffer and a protective factor to mental illness,” she says.
“Regardless of whether you access services or not, if you have a level of resilience and you have social connections with another person but also in your community, you're less likely to experience long term mental illness.”
If you or someone you know needs support, you can contact Lifeline on 13 11 14.
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.