Today the Child Poverty Action Group and The New Zealand Psychological Society has released its new report (Child Poverty and mental health: A literature review ) into the connection between children’s mental health and being poor. It adds to the chorus of voices demanding better for families and children from Government. Much much more must be done to prevent vulnerable children suffering from the debilitating impacts of rising accommodation costs, poor quality houses, food poverty, insecure low paid jobs, and insufficient support systems.
The scale of mental health problems in children
The report tells us that between 5,000-14,000 children (those up to 14 years old) and a staggering 43,000 – 64,000 young adults experience depression in New Zealand each year (this is formally diagnosed).
Young people (15-24 years) have the highest rates of suicide in New Zealand. Māori youth suicide rates are 2.8 times higher than non-Māori youth.
These statistics are derived from diagnostic criteria that are based in Pākehā cultural frameworks. So while they give us a guide to the issues at hand, all of us working in this area are aware of the limitations of such measures. As I have argued in other work it is important that we work towards a system where each community determines what is necessary for them to thrive rather than having it determined for them.
Mental health & deprivation
The report covers the clear associations between mental distress and social disadvantage- with children from resource poor backgrounds 2 to 3 times more likely to experience mental unwellness, and further self harm and suicide is more likely in children who experience poverty. The particular types of studies that are used to explore these relationships mean we can be confident the deprivation is causal not correlational with poor mental health
How does growing up without enough in New Zealand affect mental health?
Living in New Zealand without enough to cover the basics, let alone those enriching experiences that make life more than something to endure, is grim. As we discussed in our own research Pennies from heaven, the brain development of children is affected by growing up in families impacted by stress and deprivation, parent’s mental wellbeing can affect their ability to engage with children, and children themselves may experience stress, stigma, loss of confidence and low self esteem when they grow up poor and are aware of it. Recent data from the Youth 2000 study for example, analysed by Simon Denny and colleagues, found that young people who grew up in poor families who lived in wealthier neighbourhoods had poorer mental health than those poor children who grew up in poor neighbourhoods. Feeling poor, and be constantly exposed to the negative views that many people in New Zealand hold about low income families, is hardly an environment that would help a young person develop a sense of self confidence.
Targeting children who are already mentally unwell is insufficient
The writers of the new report are clear that mental health services are not sufficient to deal with the mental health problems we are seeing in children. It is relatively unusual for a professional body responsible for delivering mental health services (the Psychological Society) to say publically that their profession cannot fix this.
Dr Kerry Gibson, clinical psychologist and Associate Professor at The University of Auckland, tells us
“New Zealand’s mental health system is “overwhelmed” by increasing need”
Under investment in mental health services is one issue, and barriers for families to access it another. The Child Adolescent and Mental Health services (CAMHS) for example have long waitlists, and are not achieving their goal of reaching 3% of the population.
But greater investment in mental health services alone is not going to get to the heart of the issue.
Mental health providers are experiencing the very sharp end of what happens when we don’t invest properly in families and children before they reach breaking point. The people who go into this type of work do so because they genuinely want to help, but they are human and can only cope with the lack of commitment to enabling families in ways that work, for so long
When investment in large-scale prevention initiatives, based on evidence, is not a focus of policy, the end of line services become unable to do their work effectively.
What works to ensure children are less likely to become unwell?
Quentin Abraham, president of the New Zealand Psychological Society says that, “If we want to improve the mental health of children then we must end poverty. Some young people living in poverty show remarkable grit and determination and they may even succeed against the odds – but do we want to make their lives so hard and risk their mental health?”
As we outlined in Pennies from heaven, the evidence is clear that children’s and parent’s mental wellbeing is significantly improved when families have sufficient money to enable them to take care of themselves and their children.
Here is a table showing how the research stacks up regarding cash assistance for families and children’s wellbeing. We can see that cash assistance improves mother’s mental health in particular. The positive effects of parenting free from the debilitating symptoms of mental illness cannot be underestimated.
Table 1. Effects on Children’s Outcomes from Cash Assistance
|Nature of Outcomes||Number of Studies||Positive Effect||No Effect|
|Cognitive development and school achievement||21||16||5|
|Social, behavioural and emotional development||9||7||2|
|Subjective well-being and social inclusion||0||n/a||n/a|
|Family expenditure on children’s items||2||1||1|
|Financial stress and material hardship||3||2||1|
|The home learning environment||4||3||1|
|Maternal physical health||3||2||1|
|Maternal mental health||4||4||0|
|Parenting and parental behaviours||3||2||1|
|Source: Cooper and Stewart 2013|
Housing costs, equality and location matters too, as does timely access to mental health services when they are needed.
None of us are untouched by mental health we can all demand better for children
Mental health disorders touch all of us in some way. Many of us have personal experience or a family member or friend who has struggled with mental health issues (whether we were aware of it or not). New Zealanders from all over the political spectrum have spoken bravely of their own experiences. It is the job of any Government to ensure all New Zealand citizens are getting what they need to be well, based on what we know works. Children need the best we can give them, to ensure they have a good chance to experience a life free from the burden of low self-esteem, depression, anxiety, and self-harm. We know what works, lets insist it gets done.