BMJ  2005;330:307 (5 February), doi:10.1136/bmj.330.7486.307-b

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Q&A

Poverty and mental health

Question

Are there any recent articles or documents on the effect that poverty has on an individual's mental health? (For my dissertation.)

Leeds

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Answer

In your literature search you may find it helpful to begin with two authors at the Institute of Psychiatry in London—Robert Goodman (for child mental health) and Graham Thornicroft (for adults).

The most observable effects of deprivation may be with children under 11 years old,¹ but it is important to consider that the child who experiences poverty may also experience other life adversities.² Led by the economist Martin Knapp, a team at the "health observatory" is currently studying mental health policy and practice across Europe. This study includes the influence of factors such as housing, poverty, employment, and social justice. Poverty at a national level can affect individuals,³ and the UK social exclusion unit has been interested recently in community effects on mental health, such as in relation to neighbourhood renewal fund initiatives.

Inequalities, even in a relatively affluent population such as Whitehall civil servants, may lead to the development of depressive illness.⁴ However, the extreme, individual poverty of a homeless refugee, former prisoner, or seafarer with no benefits and no friends is clearly a risk factor for substance misuse and suicide, as the recent suicide audit in Camden illustrates and the Salvation Army has known for a century. Loss, as in the recent tsunami tragedy, includes destitution and destruction of social networks at both the level of individual mental functioning and at the level of a community's capacity to respond. On a much smaller scale, this was described acutely for several communities affected by the abrupt collapse of traditional steel or coal industries: whereas one household might have weathered a sudden financial loss, a whole town could not.

A good starting point for your reading might be a thought provoking and balanced account of one service in the London Borough of Newham for "boys, whose home backgrounds are impoverished in every sense, including domestic violence, alcoholism and sexual abuse."⁵

APU, Chelmsford

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Competing interests: Chair of the Social Care Research Group (NHS R&D Forum).

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References

1. Meltzer H, Harrington R, Goodman R, Jenkins R. Children and adolescents who try to harm, hurt or kill themselves. A report of further analysis from the national survey of the mental health of children and adolescents in Great Britain in 1999. London: HMSO, 2001.
2. Caan W. Good for mental health—an academy for the social sciences. J Mental Health 2000;9: 117-9.
3. Thornicroft G, Maingay S. The global response to mental illness. BMJ 2002;325: 608-9.[Free Full Text]
4. Marmot M. Status syndrome. How your social standing directly affects your health and life expectancy. London: Bloomsbury, 2004.
5. Hirst J. Have our kids gone mad? New Statesman 1 Oct 2000. (available at www.contac.org/contaclibrary/children24.htm).

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