The psychological cost of inequality

Inequality is at a record high in Britain, and it's costing us our happiness.

Inequality is at a record high in Britain, and it’s costing us our happiness

Yesterday’s damning report into child and adolescent mental health services found ‘serious and deeply ingrained problems’ running through the whole system.

The Health Select Committee found that while the demand for mental health services for young people is rising, many CCGs have frozen or cut their budgets.

It also said that those running the services had been operating in a ‘fog’.

As well as demanding reforms in this deeply deficient area of healthcare, the report highlighted the increasing incidence of mental health problems in children and teenagers.

It cited the rise in internet culture as a possible contributing factor to this increase – there has yet to be a comprehensive investigation into the widespread effects of issues like online bullying.

But the increase could also reflect wider issues. In 2009, the World Health Organisation published a report into the relationship between mental health and inequality. It found that countries with wide gaps between rich and poor had higher rates of mental health problems. The study suggested that, in contrast with studies of physical morbidity and mortality, mental illness rates tend to increase as countries get richer.

There are many possible reasons for this. One is that mental health problems are secondary in urgency to physical health problems which can come about as a result of extreme poverty, and so may be given less gravitas in a community.

Furthermore, it is hard to reach exhaustive conclusions. In India, for example, inequality is colossal but stigma, lack of awareness and lack of existing facilities affect the recorded demand for mental health services.

But in countries where mental health problems are well understood, we can draw certain conclusions. An assessment by Credit Suisse in October showed that Britain is the only G7 country where inequality has increased since the beginning of the century, with 54.1 per cent of the country’s wealth now controlled by the richest 10 per cent. That is higher than the rate in Sweden, where there is a much lower rate of mental health problems.

The earlier WHO report also noted this comparison, including data which showed that:

”In Britain it is very evident that some of the poorest people feel abused and disrespected by public provision and are hurt by the manner in which they are characterized by the tabloid press. Not only do they get less welfare than their Swedish counterparts, but they receive it in a context that is often dehumanizing and unpleasant.”

According to the social geographer Danny Dorling, 13.6 per cent of white Americans are prescribed antidepressants in any given year.* Income inequality in the US has risen in recent years.

There are myriad reasons for this link. Mental health problems are more common in areas of deprivation, and poor mental health is consistently associated with unemployment, fewer education opportunities, low income or material standard of living. Feelings of despondency and hopelessness, and anger at being stuck in an unfair system, can occur as a result of economic hardship and contribute to a lower level of mental wellbeing.

Spain was recently rated as having the worst inequality problem in Europe in a study by the Catholic charity Caritas, which found that 20 per cent of Spanish society is now seven-and-a-half-times richer than the bottom fifth. The charity suggested that these economic problems “produced a weakening of family ties and other safety nets”, factors which can impact emotional wellbeing.

It is not just those at the bottom end of the earnings scale who are psychologically affected by inequality. Dorling suggests that well-off people tend to bear more responsibility for promoting thinking that is used to defend inequality, and this “makes them so much more likely to be sick, especially psychologically, than the better-off in more equitable countries”.

There is also some evidence, cited by the WHO report (p.20), that social disparity itself may lead to mental health issues – it found that the overall sense of well-being could be affected by trust within the population, civic engagement and volunteering, and social integration.

Whatever the reasons for the link, it must be taken into account with the findings of the CAMHS report. The Equality Trust conducted research this year that estimated that if Britain’s inequality rate was reduced to  the average level seen in developed OECD countries, mental health illness rates could be reduced by 5 per cent, at a value of £25 billion.

That’s more money to spend on mental health treatment for some of the children and adolescents whose problems may not have been preventable.

* Danny Dorling, Inequality and the 1% (2014), p.131.

Ruby Stockham is a staff writer at Left Foot Forward. Follow her on Twitter

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