Household poverty in people with severe mental illness in rural China: 1994–2015

Abstract

Background Little is known about poverty trends in people with severe mental illness (SMI) over a long time span, especially under conditions of fast socioeconomic development. Aims This study aims to unravel changes in household poverty levels among people with SMI in a fast-changing rural community in China. Method Two mental health surveys, using ICD-10, were conducted in the same six townships of Xinjin county, Chengdu, China. A total of 711 and 1042 people with SMI identified in 1994 and 2015, respectively, participated in the study. The Foster-Greer-Thorbecke poverty index was adopted to measure the changes in household poverty. These changes were decomposed into effects of growth and equity using a static decomposition method. Factors associated with household poverty in 1994 and 2015 were examined and compared by regression analyses. Results The proportion of poor households, as measured by the headcount ratio, increased significantly from 29.8% in 1994 to 39.5% in 2015. Decomposition showed that poverty in households containing people with SMI had worsened because of a redistribution effect. Factors associated with household poverty had also changed during the study period. The patient's age, ability to work and family size were of paramount significance in 2015. Conclusions This study shows that the levels of poverty faced by households containing people with SMI has become more pressing with China's fast socioeconomic development. It calls for further integration of mental health recovery and targeted antipoverty interventions for people with SMI as a development priority.

Development and Poverty Dynamics in Severe Mental Illness: A Modified Capability Approach in the Chinese Context

“…During the past few decades, Xinjin experienced huge development. Details of its achievements were described elsewhere [ 8 ]. Briefly, it had shifted from a middle-income rural county to one of the most favored investment places in Western China.…”

“…Some vulnerable groups have been structurally marginalized by the labor market, turning more disadvantaged within the development process. These groups include the elderly, the disabled, persons with severe mental illness, and many others [ 8 , 9 ]. Promoting development may be too simplified for a complicated issue like poverty, as it is still unclear about the form that development benefits might take, and the speed at which it might occur for disadvantaged groups [ 10 ].…”

“…Having a family member with SMI is associated with treatment costs, caregiving, and income loss [ 25 ]. In general, those households are less likely to benefit from the trickle-down effect of external development [ 8 ]. Accordingly, a wider range of people could be affected by SMI.…”

Medication Adherence and Influencing Factors Among Patients With Severe Mental Disorders in Low-Income Families During COVID-19 Outbreak

“…Long-term maintenance treatment of severe mental disorders brings a heavy economic burden to patients' families ( 16 , 17 ). Growing evidence shows that patients with mental illness are more likely to drift into or remain in poverty, forming a negative cycle ( 18 , 19 ). Because of the huge population of China, a large number of families which have one or more family members with severe mental disorders live in poverty ( 19 ).…”

“…Growing evidence shows that patients with mental illness are more likely to drift into or remain in poverty, forming a negative cycle ( 18 , 19 ). Because of the huge population of China, a large number of families which have one or more family members with severe mental disorders live in poverty ( 19 ). The Chinese government has made a lot of efforts to reduce the heavy economic and social burden of these families and ensure the life quality of patients with severe mental disorders over the last two decades ( 4 , 20 ).…”