The Relationship Between Mental Health and Poverty in Low- and Middle-Income Countries

Authored by: Judith Bass

The Routledge Handbook of International Development, Mental Health and Wellbeing

Print publication date:  June  2019
Online publication date:  June  2019

Print ISBN: 9780367027735
eBook ISBN: 9780429397844
Adobe ISBN:

10.4324/9780429397844-4

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Abstract

Much of our understanding of the relationship between poverty and mental health problems is couched in the two opposing hypotheses of social causation and social selection. The former posits that the stress and social conditions associated with living in poverty are causes of, or more correctly risk factors for, the development of mental illness. The latter hypothesis, in contrast, suggests that the presence of a mental illness causes an individual to drift into poverty due to limitations in functioning and the frequent stigma and social isolation associated with this class of disorders. Whilst some disorders fit better with one or other of these hypotheses, the reality is that for most individuals living with a mental illness in low- or middle-income countries (LMICs), poverty is an endemic situation that is both a cause and an effect of the condition. This chapter will explore how, in the context of poverty, with limited economic resources for health and social and educational programming, a situation is created in which large segments of the population are at risk of developing a mental health problem. Once present, a lack of services results in the exacerbation of the problem for the individual, their family, and often their whole community, contributing to a continued cycle of poverty and ill-health. Examples will be drawn from populations in both LMICs and more stable nations, as well as those affected by conflict (either historical or ongoing). The chapter will also consider the potential impact of the Sustainable Development Goals (SDGs) 1 in breaking the poverty cycle, and methods by which this might be possible, given appropriate investment.

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