Schizophrenia Daily News Blog

The Role of Poverty in Mental Illness

Although many studies have documented a positive correlation between poverty and the prevalence of mental illness, the causal order is still unclear. Is poverty caused by, or a cause of, mental illnesses?

A recent study of 34,000 patients, analyzed by diagnosis and zipcode (to assess affluence), favors poverty as a causal factor of mental illness, rather than a result. The study followed patients over a 6 year period, and documented "little downward drift" from more to less affluent zipcode areas.

There are certainly a few flaws that may confound this finding. For example, zipcodes are not a surefire way to assess economic status. None of the patients were actually interviewed by the researcher. Furthermore, patients were only enrolled in the study following a first hospitalization. As David Duncan, a Kentucky-based mental health epidemiologist notes, this may not account for downward drift that occurs during the prodromal phase, or before the first psychotic break and hospitalization.

However, despite these considerations, the study found that out of five statistically-tested hypotheses, the most likely one to explain the data was that "stressful economic conditions bring on mental illness." The study highlighted a striking disparity between the richest and poorest communities surveyed - a mental illness prevalence rate of about 4% in the former, as compared to a rate of 12-13% in the latter.

The cause and effect order of poverty and mental illness may, of course, vary by condition. Other research shows that schizophrenia may be more likely to precipitate a downward drift in economic status, whereas conditions such as depression may be more likely to be exacerbated by poverty.

The researcher, a mental health policy expert in Massachussets, translated his findings into the following policy advice: states should allocate mental health funding to different areas based on differential illness rates rather than population size, and that poorer communities especially need more outreach programs that address mental health, as well as those to assist with jobs, housing, and education.

''We know that economic circumstances, the lack of supports, and the stresses that people are subject to sometimes overtax their cognitive and emotional and mental abilities." said researcher Christopher G. Hudson. In his opinion,
"...poverty is at least as important as innate or biological factors."

Source: "Mental illness and poverty: Does one cause the other?" (March 8, 2005). Available at http://www.boston.com/news/

For more information on schizophrenia and poverty issues, see http://www.schizophrenia.com/poverty.htm