Posts

Poverty and PTSDCommonly associated with combat veterans, Post-traumatic stress disorder (PTSD) impacts more of the global population than maybe expected. Recent studies have found a link between poverty and PTSD that reveals that socioeconomic status contributes to the majority of anxiety disorders.

How Poverty Contributes to PTSD

Mental disorders manifest in distinct ways for many people. However, the common underlying origin of Post-traumatic stress syndrome (PTSD) remains a terrifying or traumatic life event. Living in poverty often means surviving daily in vulnerable conditions, and with financial instability that limits access to necessities such as food, shelter and water. The inability to pay for expenses starts to become emotionally and mentally taxing. Poverty acts as a traumatic experience in many people’s lives and even after graduating in class status, difficulty persists to enjoy day to day life.

Symptoms of PTSD can appear within months of the traumatic event and include:

  • Avoiding: Detaching from the traumatic event by avoiding triggers such as places, situations or people.
  • Reliving: Flashbacks and nightmares due to memories that force reliving the traumatic experience.
  • Increased Arousal: An increased blood pressure or heart rate accompanied by outbursts of anger and difficulties sleeping

Some people with PTSD may exhibit all these symptoms, while others exhibit just a few. The severity of PTSD also varies from person to person. PTSD can be broken down into subtypes such as:

  • Delayed on-set PTSD: This variation refers to when symptoms of the disorder develop many years after the traumatic event.
  • Complex PTSD: This type of PTSD usually surfaces after ongoing childhood physical or sexual abuse.
  • Birth Trauma: This type occurs after traumatic childbirth.

Women with PTSD

Research estimates that 284 million people globally suffer from anxiety disorders such as PTSD. About 63 percent of people that suffer from anxiety disorders are women. In addition, women living in poverty tend to face PTSD at higher levels than any other group within the general population. The relationship between poverty and PTSD embodies that of the domino effect. Poor women’s PTSD symptoms often worsen due to the fact that living in impoverished neighborhoods risk ongoing exposure to triggers of the traumatic incident. A study undertaken by the Social Cognitive Theory also reveals that most of the women living in poverty with PTSD share a history of domestic violence and lack social support.

Treatments

It can feel nearly impossible to live a normal life with PTSD. Luckily, effective treatments exist that minimize the symptoms of the disorder. One of the best treatments for PTSD is Psychotherapy. Psychotherapy allows PTSD victims to talk about their cognitive behavioral process to a mental health professional to reduce and change reactions to triggers. Another important tool for managing PTSD is having a strong support system. The help of friends and family means everything during a mental health crisis. A support system of others that have suffered from PTSD also helps signify that a person is not alone in the experiences of the mental disorder. There are also organizations such as the PTSD Alliance, who work to educate and empower people with PTSD psychologically, economically and emotionally to thrive beyond environmental barriers. The organization currently has five international partners that provide programs to help improve the lives of those living in poverty with PTSD.

Overall, poverty and PTSD remain two prominent issues impacting people on a global scale. The connection between poverty and PTSD only further emphasizes that the more work that is done to reduce global poverty also diminishes the mental health crisis.

Nia Coleman
Photo: Wikimedia

Mental Health in South Sudan

After years of violent conflict and civil war, many South Sudanese are suffering from mental health problems caused by trauma. With little to no government funding and cultural stigma attached to psychological health issues, thousands of people struggle to cope and heal from decades of war. USAID’s program Viable Support to Transition and Stability (VISTAS) is working to bring healing and restoration to the war-torn people by conducting trauma awareness workshops.

A History of Conflict

South Sudan, the youngest nation in the world, declared its independence from Sudan in 2011 after years of civil war and fighting. Only two years after gaining independence, conflict once again erupted in South Sudan, this time between the infant nation’s president and vice president, leading to a civil war that lasted for five years. Around 400,000 South Sudanese people lost their lives during the war, including women and children, while many more suffered unthinkable traumas and hardships. According to UNICEF, three-quarters of South Sudanese children have never known anything but war, and as many as 19,000 of them were kidnapped or recruited to join armed groups. Numerous accounts of South Sudanese women being sexually abused and raped by opposition forces circulated throughout the war.

End of the War Brings New Battles

Although the fighting has officially ceased, South Sudan’s restoration is just beginning. Years of violence and trauma have left their mark on the mental health of many in the nation. Although data is limited, several studies show that the conflict has had a severe effect on the mental health of South Sudanese civilians and soldiers alike. Nearly 41 percent of respondents in a survey conducted by the South Sudan Law Society and the United Nations Development Program (UNDP) showed symptoms of post-traumatic stress disorder (PTSD). The South Sudan Medical Journal reported that PTSD, depression, anxiety and substance abuse are major health issues impacting the country. However, the conflict-riddled nation not only lacks the resources to bring healing and help to those suffering from trauma, but it also struggles to remove cultural stigma and shame from mental health problems.

Mental Health Care Lacking in South Sudan

In 2012, South Sudan’s Deputy Minister of Health, stated, “The situation is very rudimentary in terms of mental health,” and “There are so many people suffering because of post-war trauma.” Today, mental health in South Sudan is still severely under-resourced, with its 2017-18 budget allocating only two percent to the health sector, none of which was appropriated towards mental health care.

In 2019, only three psychiatrists reported practicing in the whole country. Atong Ayuel, one of South Sudan’s three psychiatrists, said that “mental illness is a huge problem in South Sudan,” blaming the problem on both the country’s underfunded health program and that mental health in South Sudan is a culturally taboo subject.

VISTAS Workshops

USAID’s program VISTAS is conducting trauma awareness workshops throughout South Sudan with two primary goals:

  1. Create a space where those suffering from trauma-induced mental health issues can open up about their experiences and begin to address them
  2. Provide communities with practical tools to collectively address mental health issues and promote reconciliation and healing

“We define trauma as a wound. It is when something shocking or abnormal happens in your life, and it overwhelms you and you don’t know how to respond,” said Thor Riek, a 32-year-old South Sudanese man who struggled to cope with trauma from his days as a child soldier. Now as a trainer for VISTAS trauma awareness workshops, Thor not only has gained the tools he needs to respond and recover from past trauma, he now shares these practical tools of healing with other South Sudanese who are also suffering from trauma-induced mental health issues. Thor hopes the workshops will give participants “a narrative that can move them forward from the cycle of violence and begin to walk on the healing journey.”

In 2018, VISTAS workshops engaged 6,452 community members in different types of trauma awareness sessions. As South Sudan works to put years of violence and war behind them, programs like VISTAS’ trauma awareness workshops bring restoration and healing to a once war-torn people, inspiring a hopeful future.

– Sarah Musick
Photo: Flickr

Mental Health in Haiti
On January 12, 2010, large scale earthquake occurred, affecting the island of Hispaniola and most severely affecting the small country of Haiti. Five years after this catastrophe, many people in this country still suffer from post-traumatic stress disorder (PTSD) and other mental health issues.

Earthquake Consequences on Mental Health in Haiti

As a result of the earthquake, over 90.5 percent of Haitians had relatives that either died or were seriously injured and 93 percent saw dead bodies. Moreover, 24.6 percent of the earthquake survivors developed PTSD symptoms and 28.3 percent developed major depressive disorder (MDD) symptoms. That accounts for more than half the population suffering from mental illness post-quake.

It is not surprising that so many people were traumatized by the event, as the quake left more than two million affected, 222,750 killed, 80,000 bodies missing, 188,383 houses destroyed or damaged and 1.5 million displaced. Before the earthquake, the mental health system in Haiti was almost non-existent mostly due to stigma.

Problems in Resolving the Issue

The good news is that the earthquake united Haitians to put some focus on mental health, still not nearly enough, but just enough to get the ball rolling. However, due to the overwhelming need for mental health services and very limited resources, most Haitians are not getting the psychiatric help they need. Now that mental health issues are more widespread, there is a stronger push for the government to invest more in training professionals and increase resources for mental health in Haiti.

One of the issues around Haitians not receiving mental health is religion. Mental health issues tend to be attributed to supernatural forces, where three out of four Haitians will see an herbalist or Vodou priests for treatment instead of seeking clinical services. This is due to both cultural beliefs and inadequate resources for mental health. Clinical practice in Haiti must include mental health treatment intersected with Vodou beliefs to effectively care for patients of the country.

Center for Addiction and Mental Health

Out of more than 90 agencies that offered outreach to Haiti, only three offered psychiatric care. Center for Addiction and Mental Health (CAMH) Office of Transformative Global Health in Canada is one of those agencies. The organization collaborates with 40 religious healers of Haiti to provide cognitive behavioral therapy in an effective way that is in conjunction with cultural beliefs.

The adoption of task-shifting, or dedicating low-cost mental health workers such as community health workers (CHWs) who operate at the community and clinic levels to supplement integrated care, will help with efforts to decentralize mental health care. These improvements are being made in Haiti, however, there is still a long way to go. More investment in the health care system is needed to implement adequate mental health treatment for those still suffering from the trauma of the quake, and more generally, mental health treatment is needed for all.

In improving services for mental health in Haiti, poverty can also be reduced. Implementing adequate treatment can have far-reaching effects, as poor mental health is often the root cause of other health conditions, and it can inhibit people from participating in social and economic development.

Although not enough outreach to Haiti involved mental health services, mental health in Haiti is improving. Through the integration of community services between psychotherapy and religious or cultural practices, agencies like CAMH are facilitating change in the country. Reducing those inhibited by mental disorders also creates more contributors to the community and less burden placed on society due to mental disability. However, more funding is needing in the mental health practice to reduce illness and poverty.

– Anna Power

Photo: Google