Poverty, homelessness and the mentally ill

Poverty and homelessness are subjects many people would rather avoid. Unfortunately, avoiding the subject doesn't change the reality that there are thousands of people in our country living in abject poverty or on the streets.

Mental illness in this group is higher than in the general population. It is estimated that between 25% and 50% of homeless people suffer from some sort of psychiatric condition and many have additional substance abuse problems.

Most homeless people with psychiatric illness are not receiving any kind of treatment. Many are not aware of their condition or that treatment is available. Struggling with poverty, mental illness, social isolation and possibly substance abuse, it is almost impossible for a person to get off the streets without direct intervention.

Among the working poor who are struggling to make ends meet, mental illness is also quite common and access to treatment is often limited by the prohibitive expense of medications or counseling services that are not covered by provincial health care.

It is not only that the mentally ill tend to experience poverty, but it seems that poverty can trigger some psychiatric conditions. Elevated stress can play a significant role in exacerbating existing conditions or triggering new ones.

For example, the stresses of unpaid bills, not enough money for rent, childcare, entertainment or Christmas gifts can cause serious distress. Also, when parents are working more than one job or both parents are working and rarely off at the same time, it can cause relationship difficulties and other stresses.

A lack of money can also lead to a poor diet that leaves people with less energy and deficiencies in important nutrients. Being in poor physical health is not beneficial to overall mental health.

Consider that a single person living on social assistance in BC is bringing home roughly $500 per month. In most areas of this province it is hard to find a bachelor's apartment for less than that amount - without considering costs for food, telephone or utilities. A person on assistance with documented physical or psychiatric disability can receive $786 per month. Needless to say, stress abounds for these individuals and families.

One recent study examined the effects of poverty on the mental health of children. Children who were living in poverty were compared with those who were not and they were followed for eight years. Conduct and oppositional disorders were much more common among the children who experienced poverty.

During the study, some of the families who had been in poverty at the outset improved their circumstances when a new business opened in their community. Children who exhibited conduct or oppositional disorders got much better once their circumstances had improved while those who remained in poverty showed less improvement in symptoms.

Obviously, it is not within every family's means to change their financial circumstances. Some ways to help ensure the mental health of children include providing them with as stable an environment as possible, showing them love and avoiding the discussion of financial stress in front of them.

Service solutions are needed to help Canada's poor who are also facing the challenges of a psychiatric condition. Improved access to treatment and education about disorders and options are necessary before it is likely that people will seek help with more regularity.Although interventions such as prevention services, specialized outreach, treatment and housing programs have been helpful in addressing the needs of the mentally ill who live in poverty, their availability is far below the need.

Government and professionals need to continue to integrate their knowledge and expertise in order to educate and better serve this group. There is, however, no substitute for a higher standard of living and more respectful treatment by social agencies.


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