Tuesday, December 6, 2016

The Vicious Cycle: Untold Stories of Poverty and Mental Illness

by Advocacy Intern Dane Kirchoff-Foster
“It’s their own fault anyway!”
There is a fundamental belief underwriting our individualist culture: each of us succeed or fail based on personal merit.  This belief, for all its attraction, is not gospel.  Let others sing the praises of American individualism--I would rather now weep for its victims.  When we believe wholeheartedly that our life is our own responsibility, we render invisible those fighting desperately to make ends meet; we become skeptical (even afraid!) of those fighting every day against their own minds to do tasks we take for granted.  Furthermore, we forget the obvious--being mentally ill makes making ends meet harder.  We also ignore that which we perhaps never knew--the stress of poverty can turn your own mind into a new enemy.
Let this blog, then, serve as a quick education.  There is a vicious cycle spinning in the background of our society, born of America’s combined failure to adequately provide for the mental health and financial well-being of its citizens.   Those experiencing mental disorders in our country are at an increased risk to fall into poverty where access to mental health resources becomes almost non-existent; similarly, those already caught in the cycle of poverty are more likely to develop mental illnesses that they have no way to treat.  Without recognizing that this cycle exists, we can only ever treat half the problem.
The vicious cycle: mental illness leads to poverty, and poverty leads to mental illness.
In case you’re not convinced of this yet, let’s talk numbers.  A 2014 Gallup poll shows an increasing prevalence of depression the longer one remains unemployed; multiple reports show that about a quarter of the homeless population in America suffers from severe mental illness, compared to just 6% in the general population; finally, a five-year-long study by the CDC concluded that income is inversely related with serious psychological distress (an indicator for mental illness), and those with serious psychological distress are more likely to be uninsured, unemployed, and in physically poor health.  All this summed up: where you find one, you’re more likely to find the other. Furthermore, there is research claiming mental illness as a major leading cause of homelessness in the United States, and more research reporting the unequivocal causal effect of mental illness on unemployment, and unemployment on mental illness.  Not only does mental illness make it harder to keep a job, but experiencing poverty increases environmental stresses that can “activate” mental illness within those that are predisposed, but would otherwise never experience its full expression.
This issue isn’t about numbers--it’s about people.
The vicious cycle between poverty and mental illness, however, is not just a pile of statistics and facts.  It’s a human issue, with human suffering involved.  Here at the Hub, we get to see the human side of the issue every time we open our doors.
At the Hub, I met a gentleman who was kind, polite, and talkative.  He seemed at ease in the space we made for people to enjoy a short lunch, and had the effect of putting others at ease around him.  He was free with his compliments and also with his stories, so I settled down to listen to the ones he had to tell.  As I listened, I quickly realized (armed as I was with all the knowledge afforded me by my undergraduate minor in Psychology and my one class on Abnormal Psychology) that this man displayed all the classic signs of schizophrenia.  This man who was so kind and gracious, and had so many stories to tell, but had no one to help him.  He seemed lonely and quite alone, and about all we at the Hub can do is give him a place to stop by once a week to pick up food and maybe have a conversation.
At that same meal, I met a woman describing her own struggles taking care of her son.  After a long and confusing process, her son came out with five different diagnoses from different mental health providers.  Because of his (and her own) low income, she found it very difficult to find any suitable treatment for him.  She researched, becoming something of an expert on medical treatments for mental illnesses, and traveled to every mental health care provider in the area.  What she found is that there are alarmingly few places to go for mentally ill patients of low income, like her son.  Out of the few there are, all are overburdened and difficult to access--particularly if prescription medicine is needed.  Despite these challenges, this woman is still an advocate for her son, which makes him very fortunate.  Due to the nature of his diagnoses, her son had no insight into his own illness, making him incapable of being an advocate for himself.  This situation is all too common, and all too often there isn’t anyone to step in on a struggling person’s behalf.
Just last week, I had the pleasure of speaking to another woman at one of our Hub coffee talks whom has worked in the mental health industry for over 17 years now.  With sadness in her eyes, she described to me why people like the woman and her son run into the problems they do.  Out of necessity, mental health care providers serving vulnerable communities have started to prioritize profit (from Medicare and Medicaid, mostly) over patient.  This shift makes it all the harder for potential patients, often drowning them in paperwork.
We’re letting down those who need help the most.
These are the stories that come out of the Hub every week, and they are not isolated.  As a society, we need to stop treating mental illness as a problem only for those who can afford and access treatment.  In fact, it’s a uniquely common problem for those who can’t.  Addressing the problem by calling it just a mental health issue, or just a poverty issue, leaves behind the droves of people who experience it as both, and who are not adequately helped by one or the other approach.  We need to make more mental health resources accessible for more people--right now, the people who need help the most are slipping through the cracks.

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