Poverty and Mental Health of Children and Adolescents

Poverty and Mental Health of Children and Adolescents Pratap Sharan, MD, PhD Address for Correspondence: Professor Pratap Sharan, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi-110029. Email: [email protected] ___________________________________________________________________________________________ The bidirectional relationship between poor mental health and the experience of poverty and deprivation has been established in adults. Poverty can lead to distress or act as a risk factor for mental illnesses like anxiety and depression. On the other hand, mental disorders also cause an enormous financial burden on individuals, their families and society. Owing to the vulnerable and dependent position of children and adolescents, social determinants are likely to play a still greater role in their development and mental health. There are multiple approaches to measuring poverty. Gordon et al used the measures of deprivation of basic needs, availability of services, and infrastructure to estimate poverty; and reported that 37% of children lived in absolute poverty in developing countries, more so in rural areas. On the other hand, Grantham-McGregor et al used the percentage of people having an income of less than US$1 per day, adjusted for purchasing power parity by country, and reported that 22% of children under 5 years in developing countries live in absolute poverty. India accounts for nearly 30% of the disadvantaged children in the developing world. Other studies have used lack of employment, and housing difficulties or area-level deprivation as indicators of poverty. Also, it is important to understand that the duration and developmental timing of poverty can have an impact on children’s and adolescents’ development and mental health. Poverty is a composite indicator of multiple psychosocial risks. Poverty is associated with lack of opportunities (e.g. education, employment), reduced access to resources and a greater likelihood of experiencing stressors. It is also associated with inadequate food and housing, poor sanitation and hygiene, lower levels of family (e.g. poor maternal education, large family size, increased maternal stress and depression, inadequate stimulation in the home, inadequate or harsh parenting) and community support, problem drinking, and greater exposure to crime, violence and abuse. Poverty also leads to stigma, social isolation or exclusion, and shame and humiliation. Hence, poverty may contribute to excess risk of poor health through multiple mechanisms.