Sun, Mar 15, 2009 - Page 9 News List

Social inequality heightens mental health problems

A new WHO report reveals that mental health problems are far worse in ‘rich’ nations that are socially unequal — and that individual treatment is not the solution


Ithas been acknowledged for some time that poverty can be a trigger for poor mental health, but a study published on Wednesday by the WHO argues that it is inequality that has the most profound and far-reaching consequences for individuals and wider society.

The study, which draws on research from throughout Europe, concludes that mental health difficulties are most pronounced in countries such as Britain, which, although rich, have high levels of income and social inequality.

The report’s author, Lynne Friedli, warned that governments need to sit up and take notice and that policymakers need to “face up to the fact” that marked improvements in mental health and well-being will depend on first tackling the gap between rich and poor.

The report, carried out by the WHO for the Mental Health Foundation, looked at recent research across a range of disciplines. It argues that only radical and broad policy changes will counter directly the trend of growing inequality. It goes so far as to say that the social and economic prosperity of Europe will depend on improving mental health and well-being.

“There is overwhelming evidence that inequality is a key cause of stress and also exacerbates the stress of coping with material deprivation,” the report says. “The adverse impact of stress is greater in societies where greater inequality exists and where some people feel worse off than others. We will have to face up to the fact that individual and collective mental health and well-being will depend on reducing the gap between rich and poor.”

So-called happiness league tables frequently show that people who live in countries without gaping income inequalities between rich and poor — Sweden tends to be at the top of such surveys, with the UK hovering toward the bottom — are generally more content, but Friedli was keen to point out that the WHO research goes “much deeper” than many of the surveys that make the news.

Commissioned to look at how mental health affects a range of health, social and economic outcomes, the study concludes that international research shows “beyond doubt” that mental health needs to be taken as seriously as physical health. Looking at the trends on physical health outcomes when a country becomes richer — which point to a positive impact on factors such as mortality rates — it found the opposite to be true of mental health.

“As countries get richer, rates of mental illness increase,” the report says.

It argues that the level of mental distress among communities “needs to be understood less in terms of individual pathology and more as a response to inequalities involving relative deprivation across society.”

The report concludes that high levels of inequality when it comes to “social status” can have a serious impact on how individuals within a society see themselves, and how this manifests itself in their overall mental health.

Echoing some of the conclusions reached by the academic Richard Wilkinson in his latest book on inequality, The Spirit Level, the report also concludes that “greater inequality heightens status competition and status insecurity across all income groups and among both adults and children.”

Bearing in mind the report’s conclusions — and the fact that Britain’s stark income inequalities are dominating news coverage of the recession — there is every chance the policymakers will be forced to take note. The WHO study is part of a growing lexicon of work examining the relationship between health, economics and well-being which, in addition to Wilkinson’s latest book, includes Lord Richard Layard’s book Happiness.

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