As part of our series of independent think pieces on children and young people's mental health, Abby Jitendra and Katie Schmuecker from the Joseph Rowntree Foundation explore the need to tackle poverty to improve mental health.
The health – mental and physical – of our children, young people and families should be a central concern for policymakers. Worryingly, there is evidence which shows that children and young people’s mental health is getting worse.
There are a range of factors at work here – from long waits for mental health support if you hit a rough patch, to bullying and the negative impact of some social media on self-image, and the devastating impact of money worries and stigma. Here I’ll set out what we know about the link between poverty and poor mental health, before pointing to some directions for change.
The cycle of mental ill health and poverty
In 2020/ 2021, the most recent year for which good data is available, JRF found that 13.4 million people were in poverty in the UK. 3.9 million of them were children, and families with more children had the highest rates of poverty by family type. There are more children than pensioners in both poverty and deep poverty, likely because of the buffering effects of the state pension.
It should be no surprise that there is a link between mental ill health and poverty. Not being able to afford essentials like food or toiletries, or sitting in a cold home because you can’t afford to top up the meter, would place stress and strain on anyone.
New JRF research out this month found more hard evidence which backs this up - there is a vicious cycle between poor mental health and very deep poverty, which we can assume also holds for children. Poor mental health increases the risk of entering very deep poverty and the social isolation and financial stress experienced by many in very deep poverty also increases the risk of poor mental health. Someone entering very deep poverty is nearly twice as likely to develop poor mental health (if they did not already experience it) than someone who remains out of very deep poverty (19.1 per cent compared with 11.7 per cent). Once in very deep poverty, people with poor mental health are also more likely to be behind with essential costs and we know that parents’ money worries can be shared by their children and contribute to stress.
For young people, the story is similarly worrying – and getting worse. Forthcoming research from JRF shows that mental ill health is becoming more prevalent across the young population (16-30), and mental health issues are substantially more prevalent among young people (16-30) who are economically inactive (excl. students) and receiving benefits. The link between poverty and poor mental health was cyclical – we found that adults that have had adverse childhood experiences such as experiencing poverty and hardship are at greater risk of poorer health, both physical and mental. And this linked in pernicious ways to economic inactivity - we found the longer someone has been out of work the more likely they are to cite mental health problems.
We also know that negative perceptions of poverty affect how people see themselves, with people experiencing poverty displaying lower levels of confidence in their own ability to succeed. This has negative physical and psychological health consequences, along with reduced educational and professional attainment. JRF has begun a dedicated programme of work to understand the impact of stigma on people in poverty in the UK, including reflecting on how we might be able to tackle it.
Reversing worsening mental health means tackling poverty
A sustained programme of change will be needed if we want to take seriously children’s, young people’s, and families’ mental health – and tackling poverty within these groups will be crucial.
First, we need to make sure that our welfare safety net acts as a real protection if we find ourselves in need of it. Currently that is not the case – we know 90 per cent of low-income households on Universal Credit (UC) are currently going without essentials because the basic rate of benefit is not tied to the actual cost of life’s essentials. This is a key driver of poverty and destitution and so is also contributing to poor mental health. UC needs reform and are calling for an Essentials Guarantee which would embed in our social security system the widely supported principle that, at a minimum, Universal Credit should protect people from going without essentials.
We also need to ensure that families are not pulled into poverty due to the costs associated with caring. The more mouths parents have to feed, the higher the risk of them being in poverty – with higher associated risks of mental ill-health. Sufficient cash support from the benefits system will be central to protecting families from going under. This means reversing the two-child limit and benefit cap, as well ensuring all parents are paying their fair share by reforming the child maintenance service system.
Finally, we know that well paid, secure work is the best route out of poverty for families. We have created systems to help families move into and stay in work and progress, but these are in dire need of reform and improvement. Take our childcare system – for some, it is too expensive to access, while some parents find it impossible to find appropriate care to suit their child’s needs or their own working patterns. And its important educational role at a pivotal time in a child’s life is not being realised for all, with variable quality across providers. As we set out earlier this year with experts Coram Family and Childcare, we need a system which balances cost with access, is family-centred, high quality, and links into wider support services. This will help parents – especially women – take on work, while helping to level educational inequalities.
The design of work also has to change to help people juggle caring responsibilities without falling into hardship. We found that the act of caring for children had a serious impact on the pay of mothers – amounting to a loss of pay of over £15,000 per year - largely due to them leaving work entirely or reducing their hours. Improving the Statutory Maternity Pay offer by lengthening the duration workers are paid at 90 per cent of their pay, and dramatically improving the Paternity Leave offer, will be two big leaps in helping families improve their pay and prevent falling into poverty.
For young people not participating in the labour market, the government needs to take a long-term view – particularly for those at risk of becoming NEET (not in employment, education or training) and inactive who have a greater risk of having or developing mental ill health. Proactive and preventive measures should be taken to support this group into work, education, or training, and support should be bespoke and psychologically informed. JRF is undertaking sustained policy thinking in this area to find solutions.
It should be everyone’s concern that the mental health of children and young people is declining. Besides the familiar (and true) trope that children are our future, the knock-on costs to society of disrupting this future through ill health are huge. Helping families and young people make ends meet should not be an afterthought to alleviate the problem – it should be our first line of attack.
This article and views reflected within it were provided and written by Abby Jitendra and Katie Schmuecker from the Joseph Rowntree Foundation.
