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Poverty and Mental Health

Monaliza Sultan Ali

A fifty year old male with the diagnosis of the depression was discharged from a psychiatric hospital, without being treated for the problem for which he was been admitted in the hospital. On inquiring it was identified that the patient’s family was not able to make the payments of the outstanding. He belonged to a low class status and his family could not make the payment of the hospital, which makes a bill of almost 1000 per day. Moreover the cause of his depression was that he was not able to meet his basic needs of the life as he belonged to very low socio economic status. He had five children and he was the only bread earner of the family. His family was the only source of coping for him. But unfortunately his family was reluctant to give him support. All this made him to get suffered with the psychiatric illness.

Many of the factors of the mental illness have been identified including, family crisis, physical illnesses, lack of social support and others. Out of them poverty is one of the chief cause of mental illness. Furthermore the factors other than poverty, for example, violence, poor physical health are more likely to be experienced by the poor people. Epidemiological studies and researches have proved the direct link between poverty and mental illness. Poor people are more prone to get every kind of illness either physical or mental. However socio economic status has been an area of least concern by the people, either physicians or institutions.

People of the developing countries like Pakistan; encounter several stressors in order to fulfill even the basic requirements of their family and for their own selves. According to Pakistan economic survey, 2000-2001, Poverty estimates based on the official poverty line suggest that the poor accounted for 32.1 percent of Pakistan’s population. This large prevalence shows the severity of the problem in the country. Moreover the increasing cost of the necessities of life has increased the burden of the common man. The most distressing and painful situation is that the institutions which are developed to treat these mentally ill patients take step back on the basis of patients financial ineligibility as evident by the true scenario mentioned in the beginning. This in turn further impairs the condition of the patient as many of the psychiatric patients have insight and abstract thinking. Especially depressive patients who are already overwhelmed by different stressor are extra sensitive to these kinds of stimulus. Although these kinds of patients can be treated within the community but unluckily the communities like ours, are not prepared enough to take this bold step. They consider psychiatric patients violent and keep them dispossessed with their basic needs. If the fact is being revealed that the person is under the treatment of any psychiatric problem, people close the door of the employment for them. Once hospitalized, are dishonored by the society and are called in lay man term as being “mental”. Therefore they become the victims of stigmatization by hospitalization. These poor people neither get the support from the society, nor from the family.

The nature of the relationship between poverty and mental illness is two way. Either mental illness can impoverish a person or the other way out. “People in the lowest socio-economic groups have eight times the relative risk of schizophrenia compared with those in the highest socio-economic group. People with schizophrenia are much more likely to be unemployed, isolated from family, and have poor educational outcomes”. (Saraceno & Barbui 1997). It’s a cycle called vicious cycle, according to which one who is poor get mental illness by depression and other stressors of life, whereas, those who are mentally ill becomes poor through unemployment, involved in drugs and substance abuse and other unhealthy life styles as maladaptive coping mechanisms. In spite the fact that poverty and poor socio-economic conditions contribute a lot in mental health and mental illness, yet this area has been ignored nationally as well as globally. Every scientist is busy in developing new technology for the treatment of the mental illness. They are trying hard in developing a drug which gives better prognosis for illness like depression and anxiety, but the real cause of the problem has been neglected. Why should one get depressed if he is given his basic needs of life? Very famous proverb that prevention is better than cure is remembered by everyone but not practiced in real. Rather than treating a problem after its occurrence, its better to stop its occurrence through certain preventive interventions.

Mental health promotion can be possible only if right from the individual, institution and government, each works on their own position and at their own potential. But the question arises over here is that how an individual can stop poverty as it is large prevailing problem. However one can make a big difference if he believes so. If one as an individual can make the difference in the life of at least one or two mentally ill person; then all together it make a big proportion. One can prevent the life of the whole family and in turn the whole generation by his proper and honest distribution of the charity. Moreover this help is not only on monetary basis. We need to understand that mentally ill people are human being. They should not be treated less than the humans. If we will accept them in our community, if we will let them work with us, that would the best treatment for them and the best contribution by one as an individual for these poor being. What they all need is love caring and their position as a human in the community. Institutions and government can play a major role on broader scale to promote mental health by improving social and economical status. This could be achieved by equitable distributions of the wealth. One gets what he deserves

In conclusion, socio-economic status has a great impact on mental health. This problem is prevailing nationally as well as globally. Considering mentally ill people as human being could be helpful strategy to promote human integrity. Individual, institutions and government all together can work at their own level to promote mentally health. Sometimes we feel helpless in helping these people out. However I personally believe that these problems can be over come through efforts like caring, helping, and educating, counseling and good therapeutic relationship.