Who suffers most from mental illness? This is a complex and difficult question to answer, almost a chicken-and-egg proposition.

There is some evidence that people living below the poverty line suffer mental illness disproportionately, but are they living below the poverty line due to mental illness, or are they mentally ill because they are living in poverty? Although many people with mental illness, either chronic or episodic, live complete, full lives, poor people generally have less access to excellent mental health care that includes not just medication but also counseling and support.

Another startling connection is that of poverty to domestic violence and mental health issues. One in four women will be victims of domestic violence in their lifetime, and these women often suffer long-term mental health issues including post-traumatic stress disorder (PTSD), anxiety, and depression. Poverty causes tremendous stress to a family, and many families are caught in a cycle of poverty and domestic abuse. Children who live in homes where domestic violence is present experience high rates of neglect and often become abusers when they grow up. Domestic abuse is the third leading cause of homelessness, a state that causes considerable trauma, both long- and short-term.

There is a racial component to incidence of mental health issues also. Minorities are less likely at any income level to seek counseling or support for mental health issues, both due to access  to care and the stigma that mental illness holds in these communities.  Former Surgeon General of the United States David Satcher put it this way:

There are major disparities in access, use, and quality of mental health services for racial and ethnic minorities,” Satcher says. “Minorities are less likely to receive mental health care, and when they do receive it the quality of [that] care is not good. Minority populations experience greater disability from mental illness than their majority counterparts. This is not because they have more mental illnesses but because they lack access to care. If you are already a victim of stigmatization [of mental illness], you don’t want to go out and announce you have a mental [problem] if you think it is going to be held against you.

According to the National Alliance on Mental Illness, the two groups most susceptible to mental illness are adolescents and the elderly. The adolescent brain is going through tremendous change, as is the brain of the elderly in terms of cognitive function. These times of life are also accompanied by rapid physical change as well as social and emotional change.  Without proper support through these two times of life, there is some evidence that the risk of mental illness increases.

Poverty, race and ethnicity, domestic abuse victims, adolescents, and the elderly: these groups have a higher incidence of mental health challenges due to a complicated mix of factors. One thing is certain, regardless of age and circumstance: access to quality diagnosis and treatment is crucial to support these groups through whatever challenges they face.

Have you seen these disparities in mental health issues in your community?

Image by Song Yoojun via Flickr

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