Poverty Term Paper:
The Social Implications of Mental Health and Poverty:
What it Really Means To Be Impoverished and Mentally Ill
More than a quarter of American adults live with a mental illness and approximately forty percent of those impacted are unable to work regularly because their illness interferes with their ability to function. For many individuals this makes it difficult to find a job that is flexible enough to meet their needs. Without means of income, individuals are unable to meet their most basic needs. They are often left below or very close to the poverty line as a result of their condition. (Dean et al. pg. 827). There are very few government programs available to assist people with severe mental illness. (Simon et al. pg.1). This leaves individuals with disabling mental illness at even more of a financial and social disadvantage than those with other conditions more widely recognized by the government. Society is becoming increasingly more aware of the widespread effects and implications of mental illness making it necessary for more effective ways of providing aid to those who need it.
The National Alliance for Mental Illness defines a mental illness as a condition that affects the mood, thinking, or feelings of an afflicted individual. There are many factors that determine whether a person might have a mental illness, such as: trauma, past experiences, and genetics. It is known that some people have a genetic predisposition for mental illnesses, but symptoms can develop independently of biology as a result of stress or other difficult circumstances. (Simon et al. pg. 1). Some mental illnesses are perceived to be more severe than others. Bipolar disorder, schizophrenia, dissociative identity disorder, and major depressive disorder are stereotypically considered to be the most severe of mental illnesses, but the reality is that each person’s case is unique. (NAMI, 2019). One person might be able to work with effective treatment of their schizophrenia while another might have difficulty doing so. Another person’s anxiety, a mental illness that is stereotypically much less severe, might prevent them from being able to hold a job even if they are receiving treatment. (Frederick et al).
Unemployment rates are approximately 95% among people living with severe mental illnesses. (Dean et al. pg. 827). This is almost 25x the national unemployment rate. Many places of work are unwilling to hire people living with mental illnesses because they believe they are a liability. Their work schedules might be unreliable because of a need to take time off for health reasons and they might not function at the highest efficiency due to their illness. (Backhans et al. pg. 429) It is questionable whether there is more of a risk associated with hiring someone with a mental illness compared to someone with a chronic physical illness, but many academics believe the stigma is the reason so many employers are unwilling to hire people with mental illness. (Dean et al. pg. 827). As a result of not being able to find work, many people with mental illness find themselves in poverty or close to the poverty line. (Anakwenze et al. pg. 147)
Poverty is one of the foremost sociological determinates of health and mental health. Alongside education, race, gender, immigration status, and access to health care. Most academics see poverty as a “multidimensional social phenomenon” because it is dependent on factors such as education and unemployment. (Simon et al. pg.1). Each year the U.S Department of Health and Human Services determines a federal poverty line based on average expenses and living costs. In 2018 $12,140 was the maximum amount an individual could earn to be considered impoverished if living on their own with no dependents. The average middle class American stresses much less about financial problems than people living in poverty, making people with a lower socioeconomic status much more susceptible to developing a mental illness related to stress. Living in poverty means limited access to basic necessities such as food, water, clothing, shelter, and education because of the cost. “Poverty in childhood is associated with lower school achievement; worse cognitive, behavioral, and attention-related outcomes; higher rates of delinquency, depressive and anxiety disorders; and higher rates of almost every psychiatric disorder in adulthood. Poverty in adulthood is linked to depressive disorders, anxiety disorders, psychological distress, and suicide” (Simon et al. pg. 1). It is a “vicious intergenerational cycle of poverty and poor health.”
Poverty and the social impact of low socioeconomic status make it difficult for many people to provide basic needs for themselves, including shelter, utilities, groceries, and health care. (Anakwenze et al. pg. 147). Most full time work positions offer benefits to employees to cover health care expenses, but not all people with severe mental illness are able to work nor are employers always willing to hire individuals with disabilities. Another option is part time work, but similar barriers exist and most employers do not provide benefits to part time workers. For the ninety-five percent of individuals living with a mental illness the reality is that they might not have money to cover rent, utilities, groceries, or health care. One of the most significant parts of the equation is the cost of health care for individuals without health insurance. Uninsured individuals face a variety of barriers when trying to enroll themselves in a plan. (Danziger et al. pg. 398). Medicaid is a federal health insurance program that provides coverage to individuals of all ages with low incomes. The programs are typically low to no cost, however they have a significant number of barriers when it comes to finding health professionals. Not all professionals accept Medicaid and a lot of mental health specific services are covered. In fact, there is a law called the Institutes for Mental Disease (IMD) exclusion that prohibits specialty psychiatric care from being covered under Medicaid. These exclusions can be detrimental to an individual’s mental health because they can no longer receive the treatments they need to recover or be functional members of society. (NAMI, 2019). By expanding medical coverage under healthcare programs and making them more accessible to low income individuals. The easiest and most efficient way to do this, in my opinion would be to implement Universal Health Care to ensure that all individuals regardless of preexisting conditions or socioeconomic status have access to the care they need and deserve.
Other solutions to the mental illness and poverty cycle could include expanding already existing programs that support individuals with mental illness. In the United States we have a variety of programs that provide for individuals with low incomes. The program that provides the most funding for people living with mental illness is Supplemental Security Income which gives aid to those over 65 or living with a disability that prevents them from being able to work enough to provide for themselves. In 2007, the benefits for an individual with no other income was $623 per month. The poverty line for an individual in 2007 was $10,210, the SSI benefits for 2007 still leave individuals under the poverty line. (U.S. Dept. of Health and Human Services). There are additional programs such as reduced rent and utility costs and SNAP that can help offset the cost of living for low income individuals, but the paperwork and requirements can be so difficult to understand that many people are barred from being able to access such programs. To further support individuals living with mental illness the government should increase program funding and allocate resources better in order to expand the program to cover more people that might otherwise fall between the cracks of the programs. (Danziger et al. pg. 398).
The Division of Vocational Rehabilitation is a federally funded program that employs individuals with physical, mental, or emotional disabilities who might otherwise have difficulty finding employment. The program was originally started to support only individuals with physical and developmental disabilities, but in recent years has expanded to include the growing population of people who are diagnosed with severe mental illnesses. (Dean et al. pg. 827.). The program has found it increasingly hard to serve the population with mental illnesses because the field is complex and so little is understood about it. Each individual’s experience with their particular mental illness is so different from another person’s that it can be very difficult to place people where they might fit best. “An ongoing difficulty with determining impairment for those with mental disorders is that mental disorders are heterogeneous. Some individuals may meet diagnostic criteria for a severe disorder without having significant impairments in functioning and other individuals with “mild” diagnoses suffer functional limitations that impede their ability to work. Impairments can be temporary or persistent and can improve and recur.” (Danziger et al. pg. 399). As our understanding of mental illnesses increases hopefully our ability to serve and provide for individuals with these types of disabilities will improve. Until medicine and research come that far it is important that we do all we can not only as a society but as the government serving the people to provide assistance to improve the quality of life of those in need. We can do this by improving support programs through expansions and increased coverage so that no American or human has to suffer because we do not understand what they are going through.
In the United States there exist several programs that allow individuals to get paid for taking care of their sick relatives such as parents and grandparents. Rather than hiring an in home health assistant or nurse a family member can opt to be paid by their insurance company to care for their relative. Under most circumstances the sick individuals need care for physical illnesses such as cancer or Dementia. I wonder if this program could be expand to the families of individuals with severe mental illness. If someone is unable to provide for themselves due to mental illness then a family caretaker could be an excellent way to care for the individual while still allowing that family member to support themselves and their dependents.
So much of the reason our government does not do more to provide for our citizens with mental illness is because of the stigma surrounding it. Most people do not know very much about mental illness and that makes a lot of people afraid to face the problem. The first step to providing better care will be educating those who need it and helping to reduce the stigma surrounding not only mental illness but also poverty. Research suggests that there is an interconnected cycle between mental illnesses and poverty and to support those with mental illness we must first make sure their basic needs are met through better and more easily accessible social programs.
Framing Statement:
Before writing this paper for my Sociology class I had never written a research paper before so I went in not really knowing what to expect or how to even approach the assignment. I collected all my research and organized it on a separate sheet so I could outline what I wanted to do. I think this was probably the most helpful part of this assignment because it kept me headed in the right direction. I think that for next time I would do a lot more research in advance so that I can spend more of the writing process actually composing thoughts rather than searching for other people’s ideas. I wish other classes had peer review built into the writing process because I thrive off of hearing what other people have to say about my work so in the future I might consider making a trip to SASC to have them critique my work.
