Inner London is the wealthiest area in Europe. However, it is also home to some of the most deprived children in the UK. Tower Hamlets, the most impoverished borough in London, simultaneously holds the ostentatious Canary Wharf within eyeshot of multi-storey council blocks. This is aptly symbolic of the widening inequality gap between the rich and poor, and the seemingly unstoppable force of gentrification. As property prices increase and wages are cut at a staggering rate, the current climate of austerity exacerbated by a Conservative government has placed immense pressure on family incomes, particularly those from working-class backgrounds. Consequently, child poverty is set to rise in the next five years because of government measures such as the benefit cap and the spare room subsidy. As the struggle to make ends meet worsens, children and young people from economically disadvantaged homes will be subjected to increasing levels of mental and physical suffering. As most mental health problems are developed in childhood and adolescence, the neglect their early years development needs will have dire, long-term consequences for their overall health outcomes, social life and relationship growth. Early intervention is necessary for their wellbeing to remain intact.
Although people from all demographics can have mental health problems, its distribution and prevalence dramatically varies across different genders, ethnic groups, and socio-economic statuses. Various studies have reported that children and young people living in low-income households (below 60% of the British household median) are significantly more likely to have poor mental health compared to their affluent peers. The National Child Development Study 1958-2008 by the Centre for Longitudinal Studies discovered that children from the lowest income group were four times more likely to display psychological problems compared to children from the highest income group. Ethnic minority groups, asylum seekers and refugees are considerably more likely to suffer persistent economic stress. However, they are less likely to access sufficient support from Child and Adolescent Mental Health Services (CAMHS). CAMHS do not consider poor children a priority group for accessing services and the referral process disregards the impact of financial and social history on mental health, despite it being a significant factor in determining an individual’s life outcomes.
The cyclical nature of deprivation is at its most transparent when exploring the snowball effect of child poverty; a causal factor and consequence of mental ill health. Poor children lack material resources such as money, sufficient healthcare and a high-quality education and are therefore more likely to live in inadequate, cold housing within unsafe neighbourhoods. They are also marginalised and stigmatised by peers, teachers and wider society which may induce feelings of isolation, shame and psychological damage. This results in lower educational attainment, hindering the chances of achieving financial stability in adulthood and increases the chances of poorer physical health outcomes such as high blood pressures, cholesterol and heart diseases. This simultaneously increases the risk of mental health issues. For example, the Centre for Social Justice found that children from the lowest twenty percent of household incomes were three times more likely to have common mental health problems such as anxiety, bipolar disorder and depression, and nine times more likely to have psychotic disorders than the richest twenty percent. Despite their close link, physical health and mental health are treated as separate entities, partially because mental disabilities can be transitory and harder to demonstrate than a physical illness.
The racialised aspect of poverty is also neglected by mental health services and government policy. Life satisfaction across London boroughs dramatically varies. The London Poverty Profile reports that ethnic minority children are disproportionately concentrated in socio-economically disadvantaged areas. Tower Hamlets has the highest rate of child poverty at 49% and more than two thirds (69%) of the borough belong to minority ethnic groups. Conversely, Havering is one of two of the least diverse boroughs in London. In 2014, 85.7 percent of the population was classified as White British and the child poverty rate was 23%. Fifteen-year-olds in London reported significantly higher low life satisfaction compared to all regions in England. However, statistics for Havering were considerably lower at 10.7% compared to Tower Hamlets at 18%. Additionally, young black people were 1.3 times more likely to report low life satisfaction compared to young white people, with percentages for white people at 13.2%, Asians at 16% and Black people at 17%.
The neglect of ethnic minority children’s mental health has received increasing attention and widespread criticism as they are overrepresented in systems such as the Criminal Justice System and social services that are known to have a detrimental effect on mental health. Specific risk factors affecting their mental and physical state which aren’t usually considered during the referral process or descriptive criteria for disorders include racism, racial harassment, racist bullying, experiences of migration and balancing the demands of multiple cultures. Supposedly “culturally sensitive” interventions and child policy initiatives lack credibility because they are based on limited, inconclusive literature that treat different ethnic groups as a homogenous entity despite their vast and complex inter- and intra-group differences. Such research has given sustenance to stereotypical, crude assumptions about communities of colour, preventing the development of services that considers ethnicity in a clinically meaningful and relevant way. Consequently, many young ethnic minority groups reach out to community-based projects, local youth centres and social networks for support, as mental health services only pay attention once they’ve reached crisis point. For care to be culturally appropriate, further epidemiological research should avoid collective terminologies that merge different ethnic groups. Effective, evidence-based engagement and treatment requires larger stratified samples of ethnic groups that incorporate the unique characteristics and aetiological factors (for example, family structure, child-rearing practices) that interplay between ethnicity, socio-economic disadvantage and mental health.
Even though the survival of our present and future youth is at stake, they are not receiving the urgent attention they require from the government or mental health services despite strong research evidence. Making employment more accessible is not the ultimate solution to improving the mental health of poor communities. Changes must occur at a policy level, as welfare cuts & benefit sanctions are having a detrimental effect on working families. Furthermore, the structure and nature of mental health services requires a drastic, holistic overhaul because it is failing the most vulnerable. The complex, interlinking social and economic realities shaping children’s’ lives must be acknowledged before services can provide transformative aid. Improving the care for the most susceptible, socially excluded children who normally slip through the gaps is of utmost importance.
- The British Journal of Psychiatry’s (2012) editorial on mental health problems in children and young people from minority ethnic groups http://bjp.rcpsych.org/content/bjprcpsych/200/4/265.full.pdf
- The Centre for Social Justice (2016) http://www.centreforsocialjustice.org.uk/core/wp-content/uploads/2016/08/MentalHealthInterimReport.pdf
- The Children’s Society (2016) https://www.childrenssociety.org.uk/sites/default/files/poor_mental_health_report.pdf
- The Children and Young People’s Mental Health Coalition inquiry on the impact of the Welfare Reform Bill 2015-2016 http://www.cypmhc.org.uk/media/common/uploads/CYP_coliation_policy_paper1.pdf
- Children and young people’s mental health: the policy, the progress made, the challenges.http://www.cypmhc.org.uk/media/common/uploads/CYP_coliation_policy_paper1.pdf
- Greater London Authority’s (2010) Health Inequalities Strategyhttps://www.london.gov.uk/sites/default/files/london_health_inequalities_strategy_-_final_-_published_april_2010.pdfMental Health Foundation (2016)
- Department of Health (2015)https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/414024/Childrens_Mental_Health.pdf
- The King’s Fund research paper on tackling poverty (2014)https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/tackling-poverty-research-paper-jrf-kingsfund-nov14.pdf
- Tower Hamlets Partnerships Child Poverty Needs Assessment (2010)http://www.towerhamlets.gov.uk/Documents/Public-Health/JSNA/Child-Poverty-JSNA-2010.pdf