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Poverty causes mental illness. How can we defeat this trap?
For several centuries, the more astute have periodically warned us that those who are poor die earlier than those who are more affluent. More recently, they also have alerted us that the poor have much higher rates of mental illness, which then entraps them in poverty. This fundamental fact should cause us to pause and then to revolutionize the practice of mental health care.
What is the evidence? More than half a century ago, research pioneers Auguste Hollingshead and Frederick Redlich (1958), followed shortly thereafter by Thomas Langner and Stanley Michael (1963), documented that poverty leads directly to high rates of mental illness. Three decades later, Richard Mollica and Mladen Milic (1986) observed a similar relationship, with slight modifications. Just recently, Christopher Hudson (2005) reaffirmed these earlier findings and also added that downward social drift due to prior mental illness is only a minor factor in the observed relationship between poverty and mental illness.
The power of this relationship has been documented through survey in the United Kingdom by Rachel Jenkins and others (1997). Compared to those from the highest social class, those from the lowest social class had the following prevalence for specific disorders: alcohol dependence (times 2);...