Poverty plan good prescription for mental health

We can and must break the cycle, Amy Lubik writes.

The Public Health Association of B.C. believes that one of the best places to start trying to curtail mental illness would be with a comprehensive poverty-reduction strategy. When one in five Canadians is experiencing mental illness at any one time, and B.C. has the highest rate of mental-health-related hospitalizations, as well as the second-highest poverty rate in Canada, it’s time to get serious about the role poverty plays in causing mental illness.

Award-winning scientist John Read describes how “poverty dampens the human spirit, creating despair and hopelessness … directly impacts learning, drug and alcohol abuse, and increases suicide, depression and severe mental illness.”

According to the Canadian Medical Association, our genetics determine about 15 per cent of our health. Instead, it’s our socioeconomic status that plays a far more significant role, accounting for 50 per cent of our physical and mental well-being.

A vast array of socioeconomic issues are at play here, including access to stable, well-paying employment, good food, a safe and stable housing situation, and access to social support. Working poverty and precarious employment are increasing, which has negative consequences on mental health, especially for those prone to mental illness.

When mental illness does strike, maintaining stabilizing factors like jobs and housing, as well as social-support networks, becomes difficult, increasing stress and worsening mental illness. Additionally problematic, according to the B.C. Psychiatric Association, is getting help can be extremely complicated even for those who have loved ones to help them navigate the system. Small but critical programs where volunteers diagnose poverty and try to connect patients with the help they need and are entitled to as citizens are few, and they need expansion. Many mentally ill people aren’t getting the care they need and may end up on the streets, exposed to new traumatic situations, as has occurred for many patients after the closing of Riverview Hospital.

When we think of our fellow human beings ending up on the street, it’s hard not to think of the ongoing fentanyl crisis. According to Dr. Gabor Mate, fentanyl is an extremely powerful drug used to treat pain, but it also targets mental anguish. Many of the people using these drugs have come from childhood abuse and neglect, which often stems from poverty and an unstable home life. Further, childhood trauma and core emotion patterns shape the developing brain in ways that make them more susceptible to addiction than people without childhood trauma. Having safe-injection sites is laudable, but we need a plan to help families out of the trauma of poverty before it disrupts child mental health.

New studies are revealing that poverty can shape a child’s mental health on a genetic level. Research from Duke University shows that low socioeconomic status in childhood triggers changes in gene-markers, called epigenetics, which may act to block the activation of a gene and interfere with the processing of serotonin, the lack of which is associated with chronic stress and depression. These changes can be made worse by other factors often associated with poverty, such as poor nutrition and exposure to smoke. When one in five children live in poverty in B.C., and there are reasons to believe that the trauma of poverty can potentially be passed down generations, we need real interventions.

For those who would say that tackling mental health and poverty is too expensive despite being the right thing to do, the Canadian Mental Health Commission estimates that mental illness costs Canada about $51 billion annually ($6.7 billion for B.C. on a population basis, not factoring in the larger-than-average mentalillness prevalence). The Canadian Centre for Policy Alternatives estimates that a povertyreduction strategy, including social supports, much-needed social and transitional housing and better access to health services would cost B.C. about $4 billion — a figure that would lessen as we break the cycle of poverty and mental illness.

Inequality is growing in B.C. faster than anywhere else in Canada, and inequality is associated with poorer mental health for society as a whole. To really alleviate some of the main factors in the development and perpetuation of mental illness, we need to address an underlying cause.

For B.C., a poverty and mental-illness reduction strategy is long overdue.

Amy Lubik is a member of the Public Health Association of B.C.’s policy, advocacy and research committee.