Poverty and mental illnesses often go together. Depending on the studies you follow, poor people are between two to nine times as likely as wealthy people to suffer from mental illness, whether depression, schizophrenia, or substance abuse.

So does poverty cause mental illness? Most researchers today acknowledge that an intersection of social, environmental, psychological, and genetic causes lead to mental disorders, though research into causes and cures have tended to focus disproportionately on genetics and drugs in recent years.

But public health experts acknowledge that the conditions of poverty – poorer medical care, fewer resources, higher levels of mortality and substance abuse – seem to themselves lead to mental disorders. Poorer people also recover at lower rates from mental illness and they are more often admitted to institutions, less likely to have jobs, and are more alone and stigmatized.

But there is one surprise: mentally ill people from developing countries are more likely to recover than those from developed countries, with double the rates of remission. This goes against experience in every other medical field, where fewer hospitals and less availability of drugs, for example, produce worse outcomes in public health.

Why? We don’t really know. The WHO in its World Mental Health Report of 2001 speculated that the greater familial support, lesser stigma, and the fact that it is easier to go back to earning your livelihood in developing countries, for example with domestic or other kinds of physical labor, help mentally ill people in countries like India do better than mentally ill people in wealthier countries.

Which is something that reinforces what I believe in: where mental illnesses and disorders are concerned, drugs alone are simply not enough. You also need to provide shelter, food – and sympathy and respect for the person who is suffering.

Susan Vinodh Pandian

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