Poverty and mental disorders: breaking the cycle in low-income and middle-income countries.
Growing international evidence shows that mental ill health and poverty interact in a negative cycle in low-income and middle-income countries. However, little is known about the interventions that are needed to break this cycle. We undertook two systematic reviews to assess the effect of financial poverty alleviation interventions on mental, neurological, and substance misuse disorders and the effect of mental health interventions on individual and family or carer economic status in countries with low and middle incomes. We found that the mental health effect of poverty alleviation interventions was inconclusive, although some conditional cash transfer and asset promotion programmes had mental health benefits. By contrast, mental health interventions were associated with improved economic outcomes in all studies, although the difference was not statistically significant in every study. We recommend several areas for future research, including undertaking of high-quality intervention studies in low-income and middle-income countries, assessment of the macroeconomic consequences of scaling up of mental health care, and assessment of the effect of redistribution and market failures in mental health. This study supports the call to scale up mental health care, not only as a public health and human rights priority, but also as a development priority.
Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa. crick.lund@uct.ac.za
Crick
C
Lund
Mary
M
De Silva
Sophie
S
Plagerson
Sara
S
Cooper
Dan
D
Chisholm
Jishnu
J
Das
Martin
M
Knapp
Vikram
V
Patel
D003906:Developing Countries; D006801:Humans; D007182:Income; D001523:Mental Disorders / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D011203:Poverty / Q000517:prevention & control / Q000523:psychology*; D011632:Public Assistance; D012307:Risk Factors; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control