If you’re a regular reader of this column, it should be no surprise to you to hear that poverty is both a cause and effect of mental health problems. I have written many times about poverty’s impact in this area and the importance of dealing with the social determinants of health including but not limited to income stability, affordable housing, food security and access to health services.
Today I want to specifically discuss children’s mental health as it relates to poverty and a recent study from the BC Medical Journal.
In this study, researchers used a case study of a six-year-old child referred for mental health treatment due to anxious and possibly ADHD behaviour presenting at school. In the child’s subsequent appointments, the family’s financial struggles became apparent and a number of factors related to these environmental circumstances appeared to be contributing to the anxiety and behaviour.
Rather than treating the child medically, the physician worked with the parents, school and other social services to improve some specific socioeconomic factors. This help included ensuring the child had access to reliable, nutritious meals through school breakfast and lunch programs; giving the child subsidized access to academic resources; assisting parents with parenting courses and helping them file income tax returns to ensure they could qualify for supports such as low income transit passes and subsidized housing. Within three months, the child’s anxiety and behaviour had improved significantly.
Of course this is one case, but it is not an uncommon situation and it is something health care providers should take seriously. Sometimes a child presents with symptoms that could indicate a mental health condition but are actually a response to environmental circumstances, which could be improved.
BC continues to have a very high rate of child poverty in spite of repeated calls to action on this front. Twenty percent of BC children live in poverty and the numbers are much higher among immigrants, visible minorities or Aboriginals. One in three children in lone parent families live in poverty and food bank use has increased by 25 percent since 2008.
The World Health Organization named poverty as the single biggest determinant of health for both adults and children. This is significant around the world but also bears out here at home. Children living in poverty experience poorer physical health and are three times more likely to suffer from psychiatric conditions.
Kids raised in poverty also tend to do worse in school – recent neuroimaging studies have found this could be partly due to underdevelopment in certain brain areas among children living in poverty.
Since we know poverty is bad for kids and results in life-long consequences, health care professionals need to be screening for poverty when interacting with families. Treatment recommendations should address socioeconomic factors.
Helping a family access resources and improve their situation can make a significant difference in the health of children and could interrupt the cycle of poverty before it moves to the next generation. This should be a priority if we are truly committed to preventive health.
Paul Latimer is a psychiatrist and president of Okanagan Clinical Trials. He can be contacted at 250-862-8141 or dr@okanaganclinicaltrials.com