A recent report by Lord Richard Layard suggests that “Happiness depends on health and friends, not money”. The conclusions presented argue that the UK government should focus more on providing better healthcare and resources for dealing with mental health issues in a variety of societal contexts, rather than trying to combat poverty and make people wealthier.
For the record, I’ve no issue with Lord Layard, and I’ve no doubt that his intentions are honourable and intended to be helpful. It is also the case, without question, that the UK government should indeed invest significantly more in mental healthcare, given the dire state it’s currently in.
However, this report and the recommendations it makes have angered many in the mental health community, and with good reason. The report seems to treat mental health issues and poverty as separate things, occasionally overlapping perhaps but with their own distinct effects and mechanisms that don’t really impact on each other. However, anyone involved in mental healthcare will tell you that this is a farcical claim when faced with the reality of the situation.
Lord Layard has stated that mental illness is a bigger cause of misery than poverty in our society. But as any credible psychologist will tell you, this is like saying bacteria is a bigger cause of cholera than dirty water; even if technically true, they’re both aspects of the same problem, and by focusing solely on one you’re never going to really deal with it.
It’s true that you don’t have to live in poverty to experience mental health problems. Many wealthy, successful types have succumbed to them. But poverty is a much bigger risk factor for mental health problems, in the same way that smoking is a bigger risk factor for lung cancer. Not every smoker gets lung cancer, and non-smokers are not immune to it, but smoking makes it far more likely.
The causes and triggers for mental health problems are many, varied and often poorly understood. There’s rarely just “one” thing that causes them. It can be genetics, trauma, or some other cause of considerable stress. And that’s a key issue: stress.
The stress-vulnerability model of mental health is a neat way of showing that our brains can only handle a certain amount of stress before a crucial threshold is crossed and we end up mentally ill. Some people can handle a lot of stress before a breakdown occurs, others not so much. The amount of stress needed to tip you over the edge depends on many factors, but a major one is how much stress you deal with on a regular basis. Typically, if you’re exposed to stressful things all day every day, your brain’s capacity to deal with it is already being used up, so it doesn’t take a great deal more until you reach breaking point and can no longer cope.
Poverty is a major cause of stress. You can’t pay your bills, buy food, cover the rent, afford to provide for your children, these are all massive causes of stress. Even if you’ve no dependants, just living on the breadline is stressful in itself. The uncertainty caused by not knowing if your job is safe? Stressful. The loss of control over your own life due to lack of certainty and financial resources? Very stressful. Turning to drink or drugs to try and make yourself feel good in spite of your situation? Hugely stressful for you and anyone who care about you. Living in a dangerous, high-crime area because you can’t afford anywhere better? Massively stressful.
These are just a small number of factors that can and do contribute to mental illness, all of which stem from poverty. To argue we shouldn’t focus on it seems extremely naïve to say the least, when you consider all this.
Maybe it’s because those involved in the Layard study are all economists, that things like this are seemingly overlooked. They’re all extremely clever people no doubt, but some questionable claims stand out, at least in the Guardian’s coverage of it. For example:
The “average” income may have doubled, but all the available data shows that income is highly concentrated in the top 20% of the population. Factor in inflation and cost of living increases, and this huge inequality should mean it’s no surprise that the “average” income is meaningless to those on the breadline. You could try explaining to them that the top 10% are considerably richer than them, but how or why this would make them happy is anyone’s guess.
Supposing this is true; how do you get a (presumably romantic) partner? Usually it involves meeting people in social situations, perhaps through friends or colleagues, and then typically dating and getting to know each other better. Even the most basic manifestation of these things requires money to be spent. Working three jobs just to make ends meet does not leave a lot of time and resources available to effectively court someone.
Even if it’s not romantic relationships, saying that making more social bonds is key to being happy still means you need the money and freedom to keep these relationships up. If you’re constantly exhausted, broke and stressed, expanding your friend circle is a very big ask.
Focusing on mental healthcare is a very valid and undoubtedly urgent suggestion for the UK government. But to do so at the expense of tackling poverty is counterproductive, to say the least. It’s wallpapering over rising damp; everything may look better, but the underlying problem hasn’t gone away and it’s now likely to get even worse.
It could also, however unintentionally, further stigmatise those worse off. It absolves those in power of any responsibility to address wealth inequality, and puts the onus on those with mental health concerns to get help, despite this not being nearly as straightforward as that suggests.
You can’t ignore the links between poverty and mental health problems. Dealing with both would benefit everyone, but as long as we have one we should expect the other.
Dean Burnett deals with issues like this in his book The Idiot Brain, available now in the UK, USA, Canada and many other countries.