Mental Health Issues

[_In Development_]

Mental health is one significant cause of poverty, but the term refers to multiple conditions, each having its own causes, characteristics, and need for support.  Here are just a few to consider:

  • Congenital conditions or birthing problems which normally contribute to some degree of permanent mental disability.
  • Early childhood conditions, possibly preventable, but often attributable to malnutrition, emotional neglect, or other forms of abuse.
  • Illness or accident.
  • Mental deterioration due to lifestyle choices and substance abuse.

In each such case, the severity of a mental illness or impairment may vary greatly; some not being observed or diagnosed immediately.  Because of common variations in physical and mental development, it is often unclear at what point one might declare that a mental disability exists. (See my note on _what is normal_)

Cases of mental illness that are commonly associated with homelessness include:

  • Fetal alcohol syndrome (FAS), or fetal alcohol spectrum disorder (FASD)
  • Schizophrenia
  • Autism
  • Depression

Prevalence of mental health problems

Of the preventable types, FASD ranks high in our local context.  It is reported that FASD affects a majority of those incarcerated in Saskatchewan.

The term “spectrum” is a reminder of the different types of effects and degrees of severity of the condition.

FASD creates havoc within family and community due to the following commonly associated conditions:

  • Attention deficit and hyperactivity disorder (ADHD)
  • Aggressive tendencies and lack of physical self-control
  • Learning/schooling difficulties
  • Weakness in logical thinking and understanding consequences (leading to poor decision-making)
  • Mental depression
  • Substance abuse
  • Inappropriate sexual behavior
  • Mismanagement of money.

Widespread attempts are now in place to educate people of the dangers of pregnant mothers consuming alcohol.  The cost of failure to control such cases impacts families, communities, and society at large with excessive costs incurred by public health and law enforcement.

Other mental health issues of genetic and prenatal origin include schizophrenia, autism, mental retardation, and chronic depression.  While little can be done to avert such problems, each condition creates a vulnerability to life issues that can beset the individual, immediate family, and the larger community throughout life.  The questions to raise in the context of pro-active interventions, what can we do to give better support and thus, help to stave off the more calamitous personal and social outcomes?

For those who suffer from depression, for instance, we find that any of the following can exacerbate underlying predisposition:

  • Abuse of alcohol and drugs
  • Poor diet, including too much caffeine or sugar
  • Lack of exercise
  • Poor sleep routines
  • Lack of leisure time as well as fun and recreational activities.

Pro-active vs re-active approaches to mental health support

The reality of increasing poverty and homelessness is currently given much publicity in local as well as national media.  Confronted with the reality of need, we have an array of responses as people and agencies step forward in attempts to save lives and alleviate the worst effects of these issues.  The need for such “re-active” measures cannot be criticized; alleviation of misery is commendable.

The need for “pro-active” measures, however, have the potential to prevent to various degrees the worsening of these effects.  Without adequate guidance and support, the number of people experiencing abject poverty and homelessness can simply be much greater.  Viewed, another way, investing in prevention may well do much to address and bend-back the trend-line on increasing poverty and its effects.

Categorizing mental health causes of poverty

Post-birth causes of physical and mental health problems are, theoretically at least, within the power of family, community, and the larger society to address with preventive education and later support/treatment measures.

Most people agree that quality of home life is critical for effective support and guidance in rearing children.  But how do we view “home life” and the conditions that encourage positive home life to develop and flourish?  To what extent is home life a product, only, of family and parenting?  Important as these are, family life is also a consequence of the larger social and cultural environment of home and family.

Again, we can view the roles of this larger social context as both pro-active and re-active.  We certainly want the larger community to step in to deal with the existence of poverty and homeless, say, in structured and organized ways, but how does and should this larger community address needs pro-actively?

One can recognize the roles of public education, public health, government allowances.  To what degree is this assumed to be adequate?  Are there questions of adequacy, or awareness of critical gaps in our community support for families?  While we have learned to rely on governments support in at least the three service areas addressed above, what is the role of the informal social sector and the strength of “lived community.” How should do we assess the functioning of community life in the context of pro-active support for family support and healthy development?  And, in how many dimensions of family and parenting, is there a need for this type of non-government support?

Responsibility for support in the interests of individual physical and mental health exists at multiple levels:

  • Individual and personal care
  • Parental and family care
  • Local community support and care
  • Government support and care and multiple levels.

In the long history of societies and cultures, the well-being of individuals was primarily determined by the first of these levels.  Governments, as we might call such national and regional leadership, tended to wage wars and otherwise use the poor and less-privileged for their benefit in support of nationalist status and protection.

We often fail to recognize the historical role of religious people and their church structures in responding, at least to some degree, care for the poor.  Christianity and other faith traditions spoke to the needs of the poor, but in Western culture, much of our ways of thinking regarding care for the poor has been a major theme of religious belief.  In the year 1900 throughout Canada, most of the hospitals and many of the schools were started and still maintained by churches.  We often fail to affirm this history as we should.

The dynamics of local community

It is within communities that relationships and friendships develop.  Communities that function well promote participation and mutual care.  It has been the long-standing pattern over multiple generations;  it is a world-wide phenomena.  But, when these levels of personal and social support fail, or are found to be inadequate, there is a breakdown of society, community, and family life, too.  In advanced societies, government agencies are expected to step in.  Over time, expectations can easily change with less common regard for local community participation and self-help, to greater reliance on government (or other external) agencies to fix the problems.

While a well-functioning home may provide significant support for individuals with some degrees and types of mental illnesses, this support generally breaks down in cases where primary caregivers, themselves, suffer from mental illness, addictions, and other forms of family disruptions.  Thinking of children, we can talk of a dysfunctional home as suffering from a deficit of love, guidance, and stability, all of which contributes significantly to the normal development of a child.  A single-parent home may already be viewed as potentially lacking in adequate support.  Mental health issues contribute to family breakdown, poverty, and a sense of over-whelming family needs.  The result frequently exacerbates and tendencies towards depression.

People affected by mental illness often find it difficult to function harmoniously with significant others who could be part of the needed supportive network.  Unable to deal with the normal level of family life frustrations, individuals too often choose to distance themselves from others in a search for greater personal freedom.  This tendency to “run away from” difficulties models an immature approach to dealing with common life problems and thus fails to model for children the disciplines needed for coping with common life situations. By extension, these same tendencies make it difficult to develop and maintain effective supportive communities.

In most cases involving mental illness and disability, there is a need to involve community agencies or government services.  This broader support may be of various types including:

  • community-generated support groups created around management of common ailments such as schizophrenia and autism.
  • community social groups, including active participation in a church community, coffee groups, and other friendship networks
  • in cases of financial distress, to register with government social assistance.

In cases of extreme family breakdown and incapacity of a primary caregiver to meet the basic needs of a child, government social services (Child Protection) may need to step in to remove a child for placement in a more appropriate environment.  Unfortunately, there is much debate over how this should be best managed.  Cases emerge, and are often given extensive publicity, where screening of placement families have failed to prevent further emotional damage to a child.  There is much complexity in many such family and mental-health situations where it is difficult to know what is the best course of action for the children.  At the very least, we need to respect the training of professionals in the   field and trust that professionalism will prevail.  Volunteers will surely have a role, but training should be valued and promoted.

Treatment and prevention

FASD is preventable.  Herein lies a major challenge, one of both education and lifestyle.  Social habits are deeply rooted in social life and culture.  Not only must one know and understand the risks of drinking alcohol during pregnancy, but one’s social network must also be supportive of lifestyle disciplines that will help prevent drinking during pregnancy.  Few of us as individuals have the power within ourselves to always make rational and adequate decisions independently of our social group.  We are always under the influence of family, friends and subcultures that either support or undermine the practices we ought to be following for our own good and that of others.

For perhaps most people with mental health difficulties, alcohol consumption and opiod use offer a form of escape from the realities of life.  For a host of reasons, feelings of low self-worth emerge with people suffering from mental health problems.  When people lack the skills to adequately care for themselves and family, or if people are also suffering rejection and discrimination for any number of reasons,  a deeply-entrenched feeling of hopelessness may emerge.

In many cases, treatments are available but much depends on an individual’s willingness to accept treatment.  Meanwhile, family disruption and continuing need for support and care for an individual or family members can drain away family and other types of support resources.

What can and should be done to address the needs of the incidence of mental health within communities?  Unfortunately, mental health problems are often enter-twined with other lifestyle problems, including addictions.  Poverty issues are complex, but in attempting to do something to alleviate the problems, there are many places to start.

I will attempt to discuss the latter in more depth in related articles.

First published:  2021/10/24
Latest revision:  2022/12/28