Children’s Mental Wellbeing is About Income, Wealth and Deprivation

Jess Berentson-ShawUncategorized3 Comments

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 OutcomesNumber of StudiesPositive EffectNo Effect

 

Children’s Outcomes   
Cognitive development and school achievement21165
Social, behavioural and emotional development972
Physical health853
Subjective well-being and social inclusion0n/an/a
Future earnings11n/a
Intermediate Outcomes   
Family expenditure on children’s items211
Financial stress and material hardship321
The home learning environment431
Maternal physical health321
Maternal mental health440
Parenting and parental behaviours321
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.

Children’s Mental Wellbeing is About Income, Wealth and Deprivation was last modified: May 18th, 2017 by Jess Berentson-Shaw
About the Author
Jess Berentson-Shaw

Jess Berentson-Shaw

Dr Jess Berentson-Shaw is a science researcher working for the Morgan Foundation. Jess holds a PhD in Health Psychology from Victoria University.Jess has over 10 years’ experience working on applying science and evidence to public policy. She worked on improving the use of science in public health practice in NZ, before working as a Research Fellow at University College in London, where she researched how doctors and clinicians translate scientific evidence into their clinical practice. While in the UK she also developed a national data collection system, which was used to determine what factors contribute to poor outcomes for women and babies during pregnancy and birth. On her return to New Zealand she directed a research group that specialised in the independent evaluation and application of research and science to health policy and practice. Jess loves science and what it can do to make the world a fairer place.

  • Graeme Bennett

    Hi Jess, what hasn’t been included in the study is the negative effects of buying lotto tickets and pokies. Both of which are regressive taxes that affect those that can least afford to buy them. But Lotto in their cynical marketing portray Lotto as an opportunity to dream. Lotto NZ put the prices of tickets up a few weeks back, and under the cover of darkness. This meant you receive the same amount of lines as previous for a 20% increase in the price of each ticket. Deeply cynical as this means the big prizes are less likely to be struck, which means better earnings for Lotto NZ. There is a another option to alleviate this regressive tax, but the CEO declined to pursue it with no reasoning.
    This solution would increase Lotto NZ profitability for redistribution in the communities, the Arts and SPORT, imagine an increase of 20% of funding and the positive effects of that. Imagine people not buying tickets and spending it on food, shelter and their families health. Lotto NZ could have a hugely positive effect on society, but the CEO doesn’t want to know. He had a few choice words for me, he said “I don’t give a f#&k where the money comes from and I don’t give a f%#k where the money goes”.
    Lotto the proverbial elephant in the room, a $1bn problem! Yes it provides $200m per year to the community but at whose expense, the very communities that pay for those tickets, and they certainly don’t see the benefits as they should.
    With a few simple tweeks Lotto NZ could be a hero of central government, but under National led govt it will never happen. Treasury will continue to demand Lotto cynically find other ways of screwing those that prop up the system.
    Will The Opportunities Party stand up?

  • Jac

    I completely agree with the intent and thrust of the article, but am disquieted that it may uncritically imply improved material circumstance results in improved mental and emotional wellbeing. There is increasing evidence this is not the case, and that our belief that material comfort will make us happy is a key driver of our epidemic of mental distress.
    It is very well supported that a basic level of income is necessary to provide the shelter, security, nutrition, clothing and education opportunities which are the starting point for human wellbeing. Further, our economic systems are observably dysfunctional and increasingly do not serve us or our planet; we serve the systems and the few who configure our economic belief systems to their advantage (see the work of Tim Jackson for an alternative vision https://www.ted.com/talks/tim_jackson_s_economic_reality_check).
    However there is increasing recognition that the material foundations for human wellbeing do not automatically improve self-reported happiness or life satisfaction, which are critical predictors of mental health and the likelihood of self-harm. See the odd mismatch here (greater income improves everything but suicide rates and environmental damage! https://link.springer.com/article/10.1007%2FBF01078817?LI=true). The rise of studies in wellness economics, happiness and human flourishing at universities around the world are a response to the understanding that being better nourished, better educated and better dressed is not enough to maximise our satisfaction with life and ensure good mental and emotional health. https://www.princeton.edu/news/2006/06/29/link-between-income-and-happiness-mainly-illusion?section=topstories . I’m sure you’re aware of all this and that your article intends to address the foundations for our children’s wellbeing rather than the edifice. But we have to stop equating the acquisition and consumption of material goods with happiness if we are to address the disease of mental and spiritual ill health, and the destruction of our environment.

  • pixman55

    I Managed to Raise My Son on a Minute amount of Money. I Let him Know the Situation and Ran a Tight Budget. down to the Last Cent. By Making Sacrifices in My Life (Going Without Food for a Day or Selling Some of My Clothes or Personal Items i Scrapped By.I Put My Focus on My Son.He Never Asked for More as he Knew there Was No More.I Chose NOT to Buy Alcohol for Myself but buy Food for my Son.I Did not Buy Lotto Tickets When i Could Not Afford it. Lotto Did put up Prices But You can Get Cheaper Options Like a $6 or $7.60 ticket with Fewer lines of Powerball Numbers ..i Used to get the $9.60 ticket ..When i Could Afford it.