While the economic and social consequences of poverty are well-documented, policymakers often overlook the psychological impacts of poverty. It is vital to understand this, as those who experience poverty undergo changes in how they feel, think and act. Poverty acts as a self-reinforcing mechanism by increasing mental health problems, altering behaviors and worsening the cognitive functioning of those experiencing it. This makes it harder for individuals to escape poverty, perpetuating its cyclical and seemingly fatalistic nature.

Poverty, Mental Health and Substance Abuse

Poverty significantly impacts mental health, and should not be underestimated. Psychiatric conditions such as depression, anxiety, PTSD, mood disorders and schizophrenia are much more prevalent in areas with high unemployment rates and poverty, with the most drastic effect of poverty being increased rates of suicide.

There is also a strong association between poverty, social exclusion and problematic alcohol use. Individuals who are unemployed and living in poor or insecure housing have higher rates of substance abuse compared to those who are employed, educated and living securely. Substance abuse problems can consume someone suffering from poverty, entrenching them in lifestyles that often result in incarceration, health shock and homelessness.

The consequences of poverty also transcend nationality and ethnicity. Across 43 countries, low incomes uniformly predicted negative psychological states and behavior. These include apathy, decreased levels of trust in communities and governments, antisocial attitudes and mental disparity.

Economic Thinking

Poverty burdens the mind and induces high levels of stress. Stress can impact mental bandwidth, which refers to how much cognitive capacity and executive control one has available. Cognitive capacity allows for complex problem-solving, retaining information and logical reasoning, while executive control determines the ability to focus, shift attention, retain things in memory, multitask and self-monitor. Poverty reduces cognitive capacity and weakens executive control, specifically in abstract thinking, due to the mental burden of financial worries, which hinders problem-solving abilities.

Furthermore, individuals in poverty tend to rely more on automatic thinking versus deliberative thinking. This is less cognitively demanding but also makes individuals less likely to consider all possible outcomes due to restricted mental bandwidth. This means most people living in poverty are only able to deal with one problem at a time, sacrificing and prioritizing only what is immediate and necessary. This is known as the tunneling effect. Tunneling is a state of mind where one can only focus single-mindedly on managing the scarcity at hand, blocking out other sections of life. Tunneling also impacts time-discounting. Impoverished individuals are more likely to lose track of long-term goals or rewards, only paying attention to the most immediate reward. Middle-income and wealthy individuals are more likely to consider future rewards and plan accordingly to obtain those rewards.

Further effects include alteration of behaviorally revealed preferences, including a decreased willingness to take present risks and accept new technologies, policies and assistance that could lead to future benefits. Reluctance to accept new technologies contributes to a paradox where impoverished individuals may avoid the very resources that can aid them.

Cognitive Development

Growing up in poverty can severely undermine cognitive development. At around 3 years old, children in low-income households begin to exhibit cognitive and non-cognitive skill differences from their higher-income peers.

Poverty-induced stress can also lead to impaired cognitive functions, including negative effects on the hippocampal memory system. The consequences of increased cortisol levels due to poverty show up in diseases such as Cushing’s and Alzheimer’s. As the hippocampus is responsible for emotions, motivation and memory, persistent stress impairs decision-making abilities. It perpetuates behavioral patterns in people living in poverty. This creates generalized behavioral patterns: increased cortisol impairs hippocampal function, forcing people into mental tunnels and changing how they make and view decisions.

Stress also reduces people’s executive control over themselves. This can lead them to become more impulsive. Stress’s chemical effects on the brain, most notably a rise in cortisol, dictate that often the bad decisions made by those who are poor are not due to low levels of intelligence but a result of poverty itself.

Breaking the Cycle

Neither cognitive constraints created by poverty nor poverty itself must be final or condemning. Modern behavioral and social sciences can lead to the creation of new cost-effective interventions, especially through targeting economic behavior.

Targeting Economic Behavior

Understanding behavior and identifying effective interventions is a complex process. Interventions must come after careful diagnosis of what the defined behavioral default is. Examples of nudging interventions include social influence, coinventing products that are easy to use, feedback or reminders, micro-incentives and physical environment cues. Reminders have proven to be a simple and effective solution when employed in the correct circumstances. In Kenya, patients receiving HIV treatments have struggled with taking their medications when needed. After health workers began sending routine text messages reminding them when to take their HIV medication, the percentage of patients taking their drugs increased by 13%.

Breaking the cycle of poverty may require policies that go further than behavioral nudging, especially for those in extreme poverty. In cases of extreme poverty, multifaceted poverty reduction programs are an impactful way to create pro-poor growth.

Multifaceted Poverty Reduction Programs

Multifaceted poverty reduction programs combine several different interventions to create an integrated approach that leads to positive outcomes. Multidimensional issues such as poverty require multidimensional solutions. Multifaceted programs include cash transfers, skills training and food subsidies. These initiatives also provide access to savings, services for physical and mental health and scheduled check-ins with program managers to measure progress. With regards to helping the ultra-poor, these programs are effective. Frequently, these programs prove to be successful in improving food security, physical and mental health, financial inclusion and time use. Also, there are upsides such as increased income and revenues, productive and household assets, political involvement and women’s empowerment.

Looking Ahead

In recognizing the psychological impacts of poverty, there is hope for breaking the cycle and improving the well-being of those affected. By understanding the cognitive and behavioral constraints imposed by poverty, targeted interventions can be developed to address specific challenges. Nudging interventions and multifaceted poverty reduction programs offer promising avenues for supporting individuals and communities, from providing reminders for medication adherence to comprehensive initiatives that address various dimensions of poverty. By combining these approaches, policymakers and practitioners can make meaningful strides in uplifting those experiencing poverty and promoting long-term positive change.

Andrew Giganti

Photo: Unsplash

Violence and Psychological Well-Being
According to a working paper by Nik Stoop, Murray Leibbrandt and Rocco Zizzamia of the Southern Africa Labour and Development Research Unit, “The ‘social causation’ hypothesis posits that circumstances associated with living in poverty — e.g. high levels of stress, malnutrition, social exclusion, lowered capital, exposure to violence — increase the risk of mental illnesses.” Therefore, links exist between poverty, violence and psychological well-being.

Intimate Partner Violence

The links between poverty, violence and psychological well-being are apparent in the case of intimate partner violence.

In Kenya, intimate partner violence is prevalent and the rates of violence toward women are some of the highest globally, according to a 2016 World Bank article. According to the Kenya Demographic Health Survey of 2014, “More than 41% of Kenyan women experience sexual and/or physical violence by intimate partners in their lifetime.” Women have experienced sexual and/or physical violence at the hands of men due to certain stressors.

A World Vision Kenya project initiated a study wherein males reported that stressors such as “unemployment, excessive alcohol and substance use and family difficulties as well as other psychosocial, cultural and gender issues” increase the inclination of violent behavior toward a female spouse. Financial stressors are likely considering that the poverty rate in Kenya stood at 53% in 2018.

The Work of World Vision Kenya

World Vision Kenya in collaboration with the Sexual Violence Research Initiative and World Bank Group Development Marketplace for Innovations to Prevent Gender-Based Violence began an initiative to decrease intimate partner violence in two peri-urban areas of Kenya.

The initiative targeted males with “common mental health problems such as depression and anxiety, acknowledging the links between men with mental health problems, alcohol and substance use and high incidences of [intimate partner violence].” The project employed a psychological intervention called Group Problem Management Plus (GPM+) for men with common mental health issues.

Charles Barbuti, an attorney and former New York City Police Department captain, told The Borgen Project that when certain stresses occur, many males feel stuck and helpless and “don’t feel that they have an outlet.” As such, some men turn to violence. The frustrations of unemployment and financial issues and the cultural expectations of a man’s role as the provider contribute negatively to mental well-being. The initiative that World Vision Kenya launched looked to address the links between poverty, violence and psychological well-being.

Psychological Well-Being and Violence

Researchers have comprehensively researched the correlation between poverty, violence and psychological well-being as each factor can be a symptom of the other. One of the many consequences of intimate partner violence is the development of severe psychological issues.

According to the World Health Organization (WHO), “About two-thirds of women receiving mental health services have experienced intimate partner violence/domestic violence, a number higher than the general population.”

A study published in April 2022 by Claire Bahati and others used data from the 2018 Rwanda Mental Health Survey to identify correlations between intimate partner violence and mental health issues.

Findings from the cross-sectional study revealed that “the prevalence of all types of mental disorders was significantly higher in participants exposed to IPV than in non-exposed (p ≤ 0.001).” Furthermore, the subject group with exposure to intimate partner violence had higher rates of major depression, post-traumatic stress disorder and panic disorder as well as other disorders.

The Low-Income Link

When asked if intimate partner violence is higher in households that are suffering from poverty, Barbuti responded: “It may just be a correlation problem, but it does seem that it is more prevalent in lower-income environments.”

A cross-sectional study titled Income, Gender and Forms of Intimate Partner Violence published in July 2017 looked at the correlation between income and different forms of intimate partner violence among males and females. Data for this study came from the Mater-University of Queensland Study of Pregnancy in Brisbane, Australia.

The study found that “relative experiences of almost all forms of IPV (with the exception of physical abuse in males and harassment in females) are highest when both partners report receiving low income.” In addition, the study found that females in lower-income households are most susceptible to physical abuse, emotional abuse and severe combined abuse while males are more susceptible to experiencing harassment and severe combined abuse.

According to the Child Poverty Action Group, “Women in households with low incomes are 3.5 times more likely to experience domestic violence than women in slightly better-off households.” Child Poverty Action Group helps address the stressor of poverty in the U.K. by providing assistance and support to struggling families and children through payments, advice, free school meals and advocacy work.

Looking Ahead

By analyzing the links between poverty, violence and psychological disorders, organizations can address the root cause of the issues and develop more effective initiatives to combat poverty, violence and psychological disorders. Initiatives by organizations such as World Vision Kenya aim to reduce intimate partner violence by addressing stressors and the mental health illnesses associated with such violence.

– Yonina Anglin
Photo: Flickr

Mental health in ItalyItaly is the fourth most populous nation in Europe, with a population of 60.36 million people as of 2019. As it stands, Italy remains one of the most COVID-19 affected countries, and the resulting lockdown has had a noticeable impact on the mental health of the Italian population. However, there is more to the story of mental health in Italy than the effects of the pandemic.

Italy’s Past Relationship with Mental Health

Italy passed Law Number 180 in 1978. Law Number 180 blocked all new admissions to Italian mental hospitals. This subsequently led to all mental hospitals in Italy closing by the year 2000. This change came about so that mental patients would receive similar treatment to other patients with physical ailments. Psychiatric wards that still exist in the country are located inside general hospitals with roughly 10 available beds in these wards per 100,000 people, and only 46 beds per 100,000 people in community residential facilities. These numbers can also vary significantly between geographical areas.

The State of Mental Health in Italy

In the years leading up to the COVID-19 pandemic, Italy had been doing relatively well in terms of mental health. For example, in 2016, Italy had one of the lowest suicide rates among G7 countries, at 6.3 suicides per 100,000 people. This is less than half the rate of the United States in 2016, which was 13.3 suicides per 100,000 people. The World Health Organization (WHO) estimated that in 2017, 5.1% of the Italian population suffered from some form of depressive disorder and 5% of the population suffered from an anxiety disorder.

The Effects of COVID-19

The full effects of COVID-19 on mental health in Italy are unknown. However, psychological studies conducted while lockdown measures were in place provide some clarity on the subject. One online survey issued approximately four weeks into lockdown measures in Italy showed notably increased rates of post-traumatic stress syndrome, symptoms of depression, insomnia, symptoms of anxiety and perceived stress.

The Future of Mental Health in Italy

According to experts, there are going to be psychosocial and economic ramifications resulting from the COVID-19 pandemic. Additionally, due to the trauma associated with being a frontline worker, there is a projected decline in the mental health of frontline doctors and nurses. This decline will also affect members of the Italian population that have undergone any psychological distress because of the pandemic.

Steps have already been taken to help those suffering from COVID-19-related stress. In March 2020, the Italian government launched a national mental health service intended to combat the rise of mental distress in Italy. The program works with institutions and regional associations to provide free emergency help from psychoanalysts and psychologists. The new mental health service can also provide necessary mental resources to low-income families and individuals living independently as they are more at risk of developing mental health disorders.

Additionally, SOS Children’s Villages, an organization that has also taken action on the issue of mental health in Italy during COVID-19, has partnered with the International Federation of Red Cross and Red Crescent Societies, the City University of New York and the WHO to train individuals on how to provide low-intensity psychological interventions to individuals in need of psychological aid.

The “Living with the Times” toolkit made by the Inter-Agency Standing Committee Reference Group on Mental Health and Psychosocial Support also helps to provide adults with the tools necessary to support one’s mental health, as well as the welfare of those around them.

Italy has a unique relationship with mental health treatment, and COVID-19 presents an unusual challenge for the nation. Efforts by the institutions that have partnered with the Italian government, as well as local NGOs and nonprofits, aim to reduce the damage caused by COVID-19 by making mental health care widespread and accessible.

– Brendan Jacobs
Photo: Unsplash

The Healing Power of ArtWhile charities and humanitarian organizations ensure that children refugees receive food, blankets, shelter, vaccinations and malnutrition screenings, it is easy to overlook the other side of war and displacement – the psychological impact – and the healing power of art.

Refugees and Mental Illnesses

There are 25.9 million refugees around the world and over half of them are children under 18. Children refugees are more at risk of trauma and psychological disorders, such as post-traumatic stress disorder (PTSD), with rates ranging between 50 and 90 percent compared to 10 and 40 percent in adults. Even major depression rates are higher among children refugees than adults.

The distress caused by war is often chronic, with one study showing 45 percent of participants still suffering from depression and PTSD three years after the Bosnian war. Fourteen different studies also show a significantly higher trend of disturbance among displaced individuals living in refugee camps than nondisplaced individuals or those living temporarily with relatives, even when nondisplaced individuals experienced significant trauma.

According to UNICEF, 2.5 million Syrian children are living as refugees in Egypt, Iraq, Jordan, Lebanon and Turkey. In Jordan, nearly 100,000 out of the 1.4 million Syrian refugees reside in Za’atari, a refugee camp. Syrians refugees have no legal right to work in Jordan and tensions are mounting between the two populations. Humanitarian organizations are struggling to provide food, shelter and medical care, so people often overlook educational and creative activities for children.

Artolution and the Need for Art and Expression

According to Joel Bergner, co-founder of the public art organization, Artolution, “The kids, most of whom went to school in Syria, now roam the refugee camp with few rules or structured activities. They are very rough and frequently get into fights. Yet, at the same time, they are also really sweet and friendly.”

If the international community seeks to rebuild war-torn countries or reintegrate child refugees back into a functional society, then psychological treatment is just as necessary as the physical. The trauma of war will lose whole generations if people underestimate the healing power of art.

Bergner seeks to reverse the trend of trauma, aggression and marginalization by giving children something to do with their time and by recognizing the healing power of art. Advances in neuroimaging have shown that the Broca’s area of the brain, associated with speech and articulation, actually shuts down after an individual experience’s trauma. People call this change speechless terror, which makes expressing, and therefore, managing a trauma significantly harder. However, the sensory areas of the brain that process trauma also play a role in art-making. This allows creating art to become a voice for those unable to express their trauma and reconcile their emotions.

Art Therapy

The first use of the term “art therapy” was in 1942, following Adrian Hill’s service in World War I. Hill was a British soldier, author and an official war artist whose work highlighted the healing power of art-making. Since then, art therapy has taken on various forms beyond being a method for a therapist and patient to communicate. It can involve drawing, painting, dance, theatre and song.

According to the American Art Therapy Association, the art-making process helps foster self-awareness, manage behavior and develop social skills while reducing anxiety and increasing self-esteem. The most effective art therapy models, though, are those conducted in groups and that include a discussion. This helps prevent avoidance and emotional numbing often associated with PTSD.

The organization, Artolution, is a collaborative art-making project that connects children to positive role models and their peers, but it is not only that. In Za’atari camp, the Syrian artist, Jasmine Necklace, co-facilitated a community mural alongside Bergner as well as Syrian and Jordanian children. This practice allows for discussions among refugee youth so they can talk openly about their trauma.

Art therapist, Melissa S. Walker, says that she and her colleagues have seen the healing power of art therapy through its ability to overcome the speech-language barrier in veterans, allowing them to work through their traumatic experiences in a way that feels safe.

Art therapy programs such as these have found root across the world, as more organizations acknowledge the healing power of art. UNICEF helped develop a drama program in Slavonski Brod, a town in Eastern Croatia, to help children overcome the psychological effects of the Yugoslav Wars. A counseling project for Sudanese refugees utilized drawing, theatre, writing and storytelling to help children traumatized by civil war. The nonprofit organization, War Child, sponsors art-therapy projects in the Caucasus for children refugees and those damaged by war.

Just as any humanitarian organization seeks to improve the lives of children, art therapy projects help heal the psychological wounds of war. It gives refugees a channel to communicate and a chance to rebuild their communities.

– Emma Uk
Photo: Flickr

Does poverty lead to a negative state of mind, or does a negative state of mind lead to poverty? Are the two connected at all? What role does psychology play in understanding poverty?

The psychology of poverty is another facet of poverty’s debilitating toll on individuals. An article by the Association for Psychological Science states that people who deal with “stressors” like poverty and discrimination are more susceptible to physical and mental disorders.

Studies have demonstrated that children who grow up poor have lesser amounts of gray matter in their frontal and parietal lobes. Poverty also affects the size of their hippocampus and amygdala, parts of the brain responsible for memory, learning and processing social and emotional information. Furthermore, children from poor families have decreased access to cognitive stimuli. Cognitive stimuli include things such as books, computers and other learning resources. These effects impede a child’s learning ability.

Psychology Problems Linked to Poverty

Living in poverty, especially persistent poverty, increases an individual’s likelihood of suffering from anxiety, depression and attention problems. These are complex symptoms that provide more barriers to escaping poverty.

Martha J. Farah, a University of Pennsylvania professor, says that studies have shown that many people think that those who are poor are poor because they do not try hard enough. She says that neurons should not be blamed, though.

Commenting on Carson’s statement about poverty as a state of mind, Gary Evans, a professor at Cornell University, said that “he’s correct in identifying that there’s this link [between the state of mind and poverty], but I think he’s got the relationships backward.”

The American dream mentality that encourages individuals to pull themselves up by their bootstraps and march onward towards a better life has merit in its promotion of perseverance. Its harms, especially when intermingled with poverty, lie in its tendency to individualize progress. In other words, it may frown upon outside help. Furthermore, it may diminish the complexity of poverty’s hold on households.

The psychology of poverty further demonstrates its complexities. And complex problems rarely have simple solutions. Poverty is a beast that must be tamed collaboratively with individual insight, community collaboration, a national passion and global innovation.

Rebeca Ilisoi

Photo: Flickr

Bradley Ariza, a man living in the U.K. with his girlfriend and children, is stressed all the time. In addition to constant hunger and insecurity, he needs to carefully calculate every calorie he eats to make sure he has enough, and count every penny he spends to ensure that his finances remain in order. He feels the constant pressure to maintain certain living standards for his family. Poverty becomes a “physical and psychological condition,” not just an economic one.

Studying the psychological effects of poverty is not usually met with enthusiastic approval. In the past, such research was often tainted with racism. It was also accused of being a way of blaming the poor for their behavior. Sometimes it has been seen as unnecessary because of the belief that although the poor are more deprived, they are happier. However, scholarly and public opinions are becoming increasingly more open to studying the effects of poverty on psychology and behavior. It is slowly beginning to be seen as a way to tackle poverty.

Poverty creates a “mindset of scarcity,” as behavioral economists Sendhil Mullainathan and Eldar Shafir have termed it. People are more likely to focus on current, pressing issues rather than long-term ones, even if they might be as important to their well-being. For instance, Indian farmers might prioritize their coming harvest over vaccinating their children. Some researchers have even found that the IQ of Indian sugarcane farmers falls just before their harvest.

Studies have already shown that poorer people have elevated levels of stress, and it is also widely known that stress is linked to depression. Depression, which causes absenteeism and lower levels of productivity, costs the U.S. and U.K. up to one percent of their GDP each year. People who are suffering from extreme stress and depression are less likely to make long-term investments in their health and education. They are more inclined to seek short-term rewards rather than long-term ones because they find it harder to delay gratification. These psychological effects of living in poverty make it more difficult for people to climb out of it.

Researchers are now exploring whether lowering stress and depression can improve people’s mental states enough so that they make better financial decisions and are more motivated about their future. When they are offered more psychological-centered treatments, such as therapy or counseling, people might be more likely to build a path out of the poverty trap. Studying this connection could also help explain why aid sometimes does not seem to work as it should. Microloans, for instance, might be financially helpful, but the added stress to repay loans might make poorer people’s lives worse.

Direct aid, instead of microloans, might be more beneficial. Johannes Haushofer, founder of the Busara Center for Behavioral Economics, has started studying how stress affects one’s ability to make good financial decisions. He found that giving unconditional cash transfers to families lowered their levels of depression and stress. In turn, they were more likely to make long-term, thought-out financial decisions. The effects were especially prominent when the cash transfer was a big enough size and given to women.

Radhika Singh

Sources: Foreign Affairs, The Guardian, Harvard
Photo: The Prisma