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Through Social Health Determinants (SDH), it is possible to understand the relationship of mental health with the society. Mental health is a concept that is related to both social and emotional wellbeing (Germov, 2005). The social origin of health can be explained through comparison of life expectancy in various countries. Good mental health leads to longer life expectancy. In the least developed countries, life expectancy is lower compared to the developed countries. Mental illness is a clinically diagnosable illness and includes moods disorders such as depression, anxiety and bipolar disorder. Mental health has been proved to be influenced by various factors social factors. For example, research shows that there is a link between income level and average health (Willis, 2011). Among those suffering from mental health, a large percent do not receive treatment. Society also faces a lot of challenges from mental illness ranging from stress, heavy demands on social services, and costs of treatment. This essay analyses health illness as a social issue. This is based on the concepts of poverty, class and race.
Mental health as an issue in the society can be traced to the Social Health Determinants (SDH). It is a condition that leads to high costs to the affected families. Mental illness makes it hard for those affected to contribute to the society (Ustün, 1999). According to the social model of health which is also referred as new public health, mental health is defined as a social issue. The model looks at the SDH and means of health intervention. The model is derived from psychology and shows that human health is affected by social determinants such as poverty, social class, ethnicity, race and gender. Ill health comes out as a result of interaction between a person and the environment (Germov, 2005). This shows that social determinants play a major role in health.
The health inequalities brought about by social class, poverty, racial discrimination and gender has a major role in determining occurrence of mental illness (Kawachi & Berkman, 2001). Thus, it is evident that any effort to address mental illness must focus on these factors since illness is socially produced. An example is stress caused by poverty and social inequality. In most of the societies, social inequality is common (Willis, 2011). The existing social structure and institution plays a major role in society mental health. To improve mental health, it is vital to address the existing social structure. For example, rising costs of living leads to homelessness and high levels of poverty. When population is living under poverty line, cases of mental illness are high (Germov, 2005). This is also evidenced in societies which are highly divided into social castes.
Mental ill-health and poverty are highly linked in a complex negative cycle. Research shows that mental disorders are twice as high among the poor compared to the rich (Samaan, 2000). Depression ranges from 1.5 to 2 times higher among those in low income bracket compared to the high income group. According to World Health Organisation (WHO), people who have hunger or in debt are highly likely to be suffering from mental illness (Patel and Kleinman, 2003). Most of the common mental disorders occur among those in poor housing and homeless. Based on research, it has been discovered that poverty and mental illness have cyclical relationship. Poverty increases occurrence of mental disorders and also mental disorders increases chances of being poor (Patel and Kleinman, 2003).
Poor people lack adequate resources to finance a basic living standard. In most cases, they have low level of education hence high chances of being unemployed. They are exposed to poor living conditions with poor access to health facilities (Samaan, 2000). Having poverty means an individual ability to earn is reduced since they cannot work to full capacity. This makes poverty to be a consequence of poor mental health. Also, poor mental health may occur as a result of being poor. This is due to the stress of managing a lean income. An example is people living in slums and having a burden of educating their children. Poverty also leads to low self-esteem which may result in poor mental health (Germov, 2005). This is especially with the stigma which is associated with the welfare receipt system.
Lack of employment in a society increases levels of poverty. This makes it hard for people diagnosed with mental illness to access health care. Also, a lot of money is spent on wrong and ineffective mental health care which leads to more loss to society and the individual does not get well (Samaan, 2000). In a supportive community, those with mental illness are protected from poverty and illness. Despite this, most of people with mental disorders faces disintegration of social support and are stigmatised (Patel and Kleinman, 2003). They also face marginalisation and social exclusion. This worsens their mental health and enhances the cycle between mental health and poverty.
A Psychiatric epidemiological survey in the 1930s was able to show that mental illness was prevalent in low income societies (Lauber et al., 2004). This is due to fact that poverty uses economic stressors which includes unemployment and poor housing to precede mental illness (Samaan, 2000). Poverty has psychological impacts which are mediated by stigma, exclusion and humiliation (Huxley & Thornicroft, 2003). People living in poverty have high levels of hopelessness and lack of control in their circumstances (Patel and Kleinman, 2003). This leads to low levels of satisfaction with life and this makes it hard to change the socioeconomic status.
Both absolute and relative poverty contributes to poor mental health. According to Kawachi & Berkman (2001), in relative poverty, one is dissatisfied with their lives as compared to others. This correlates to a lot of emotional distress. In developing countries, the society is experiencing a rising inequality. This leads to high cases of depression and anxiety as social gap widens. Working poverty is defined through deficiency in finances and poor living standards. This is where the working population is lowly paid which lead to mental disorders. With insecurity of flow of income, cases of mental disorders become common (Germov, 2005). An example is high suicide rates among small scale farmers in India who have failed to cope with the rising standards of living in a rapid globalising society (Patel and Kleinman, 2003).
Women have an increased risk of mental disorders. A study done in India showed that women suffer from poverty and deprivation in addition to stress associated with womanhood. Women living in poverty show a link between psychological distress and poverty (Patel et al., 1999). This is due to their role in rearing children, inequality and a sense of powerlessness. During pregnancy, cases of depression are high associated with socio-economic deprivation and other issues in their intimate relationships (Huxley & Thornicroft, 2003). It is common for women to sacrifice some of goods and services on behalf of their children. Stigma is high in those in those from poor economic background (Lauber et al., 2004). People from low economic background are highly venerable due to exposure on poverty and other economic issues (Germov, 2005).
Race and ethnicity plays a role in determining level of education, place of residence and lifestyle among others. Mental illness is affected by the race and ethnicity in a great way according to research. In countries such as USA, research has shown that mental illness prevalence is influenced by race and ethnicity (Karch, Barker & Strine, 2006). Racial minorities have low access to mental health care. Also, a lot of research on mental health underrepresents the minorities. It is important to note that racial minorities faces barriers due to poverty and high level of stigmatisation. The society has barriers which makes it hard for the minorities to look for mental health care. The culture from which a mental patient comes from has an impact on how they look at mental health (Samaan, 2000). Failure to tailor mental health services according to minority culture has also contributed to the problem.
According to Fernando (2010), race and ethnicity continues being associated with type of neighbourhood, job and healthcare. There are additional barriers faced by the racial minorities in accessing mental care. This includes mistrust, racism and discrimination in accessing health care (Fernando, 2010). Minorities in most countries have a history of racism and discrimination which may also affect their mental wellness and also contribute to their poor social economic status (Karch, Barker & Strine, 2006). The high burden of mental illness among the minorities is a major concern to the public health and society (Fernando, 2010).
One of the most tragic consequences of mental illness is suicide. In 2010, United States of America witnessed about 38,000 deaths linked to mental illness (Reeves et al., 2011). Almost three quarters of these suicides can be avoided through treating mental illness and early intervention. The consequence of mental illness does not only have consequences on immediate family but also to the society. This is due to high costs incurred in treating mental illness (Rice, Kelman and Miller, 1992). Global costs in treating mental illness were estimated at $2.5 trillion. Also, there is cost related to the lost economic output which is approximated at $16 trillion. These costs are just estimates and does not account for the immense social burden caused by mental illness (Becker & Kleinman, 2013). This includes costs incurred on family disruption, social welfare programs and homelessness among others.
According to a research by WHO on the global burden of disease, mental illness accounts for 15 percent of the burden in established market economies (Lopez & Mathers, 2013). This is higher than the burden which is associated with all types of cancer. Five out of ten leading cause of disability globally are mental illness related problems. In the workplace, the impact of mental illness is high both for the individual and the enterprise (Rice, Kelman and Miller, 1992). This is due to reduce employee performance, absenteeism, and staff turnover.
Mental illness leads to disability which impacts the entire society (Rice, Kelman and Miller, 1992). Based on the age of the beginning of a mental disorder, an individual working capacity is highly reduced. The society faces a major cost as it is forced to exclude people with disability from taking part in active live. This leads to a diminishing productivity and loss in human capital (Germov, 2005). For those living with disability, social exclusion is a major barrier to overcome. This is especially due to fact that it is accompanied with fear, shame and rejection (Almedom, 2005).
The community is made to cater for the costs of care for those affected by mental illness. This includes cases of violence resulting from mental illness and a decline in productivity (Rice, Kelman and Miller, 1992). The global spending on mental illness is high with countries such as USA having to spend about 2.5 of their GDP on caring for mental illness. Despite this, few countries have a concrete mental care plan which can help them in reducing this cost. Mental illness leads to a reduction on the quality of life among those affected (Germov, 2005). The society is thus highly affected both directly and indirectly from mental illness. In Australia, the costs of supporting people with mental illness are estimated to be at least $28.6billion (Russell, 2014). This shows that the society carries a huge burden in caring for the mental illness.
According to WHO mental health is an integral part for the wellness of the society, individuals and countries (Patel and Kleinman, 2003). Mental illness continues being a major threat to the society and economy. The evidence shows that mental illness continues to grow in societies (Ustün, 1999). Studies also show that direct and indirect costs of mental health will continue to increase in coming decades if nothing is done to cater for mental illness (Rice, Kelman and Miller, 1992). It is important to note that it is easy to underestimate the costs of mental illness. According to the experts, there is need for more funding to cater for mental health promotion (Germov, 2005). This includes mental illness prevention and early intervention measures. Some of the losses due to mental illness can be measured while others cannot. This includes the poor and racial minorities (Rice, Kelman and Miller, 1992). For the sufferers of mental illness, their quality of life is reduced and this continues even after recovery (Andrade et al., 2014). The result is a huge burden to the entire society.
Through use of sociological perspective, it becomes possible to look at mental illness as a social issue. This is due to fact that mental illness has social origins as explained through SDH. The social origins as seen in this case are race and ethnicity, level of poverty, gender and social class. It is evident that the population in low social class and those living in poverty have higher possibility of developing mental illness. For the developing countries, cases of mental illness are high due to poverty. There is a cyclic relationship between mental illness and poverty. It is also important to understand racial aspect of mental illness where racial minorities have higher burden of mental illness. There is also proof that women are affected by mental illness at a higher rate due to their roles in society. The costs of mental illness are very high in the society. This ranges from reduced productivity to the costs of caring affected individuals. This shows that mental illness is a social problem. Through social model of heath, it becomes possible to understand mental health as a social problem.
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