https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(11)60827-1.pdf

Child and adolescent mental health worldwide: evidence for action

The Lancet Commission on global mental health and sustainable development.

Poverty in the United Kingdom

This article suggests that while mental health problems affect 10—20% of children and adolescents worldwide, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries. The authors review the evidence and the gaps in the published work in terms of prevalence, risk and protective factors, and interventions to prevent and treat childhood and adolescent mental health problems.

Poverty remains one of the most pressing problems facing the world; the mechanisms through which poverty arises and perpetuates itself, however, are not well understood. Here, we examine the evidence for the hypothesis that poverty may have particular psychological consequences that can lead to economic behaviors that make it difficult to escape poverty. The evidence indicates that poverty causes stress and negative affective states which in turn may lead to short-sighted and risk-averse decision-making, possibly by limiting attention and favoring habitual behaviors at the expense of goal-directed ones. Together, these relationships may constitute a feedback loop that contributes to the perpetuation of poverty. We conclude by pointing toward specific gaps in our knowledge and outlining poverty alleviation programs that this mechanism suggests.

http://science.sciencemag.org/content/sci/344/6186/862.full.pdf

On the psychology of poverty

Poverty and common mental disorders in low and middle income countries: A systematic review

Children's experiences of corporal punishment: A qualitative study in an urban township of South Africa☆

Recent surveys in South Africa have demonstrated that disordered eating is equally common among black and white female students. Self-report measures have been used in these surveys to establish levels of disordered eating. One study in Tanzania, where a two-stage design was implemented, showed that upon interview the majority of participants did not present with disordered eating. The absence of two-stage studies in South Africa brings into question some of the findings from these surveys. In the present study, we surveyed a sample of black and white high school students in South Africa to establish the prevalence of disordered eating. In the second phase of this study, we attempted to interview those black students from one particular school who scored high on the eating disorder measures. This process proved both challenging and elucidating. While a significant number of young black females endorsed eating disorder symptoms on self-report, interviews with some participants showed that self-starvation and related symptoms had a different meaning from what we would typically expect from someone with an eating disorder. Consequently, this study highlights the need to revisit the methods typically employed in cross-cultural research in eating disorders. Careful consideration of a variety of cultural factors that may alter the meaning of standard measures is called for.

/pdf/the-meaning-of-self-starvation-in-impoverished-black-xktxxoqxtn.pdf

The meaning of 'self-starvation' in impoverished black adolescents in South Africa.

The integration of mental health services into primary health care and the shift towards community- and family-based care for chronic mental disorders has been associated with increased burden on households. At the same time, research investigating the impact of policies of cost recovery for basic services such as water and electricity has also indicated an increased burden on households. This study aimed to investigate the impact of these basic service reforms on households caring for a family member with a chronic mental disorder in Cape Town, South Africa. The findings indicate that factors associated with service reforms may increase the stress and burden experienced by households and in turn impact on the primary environment in which care is received.

Alison Breen

Papers

Poverty and common mental disorders in low and middle income countries: A systematic review

Children's experiences of corporal punishment: A qualitative study in an urban township of South Africa☆

The meaning of 'self-starvation' in impoverished black adolescents in South Africa.

Experience of mental disorder in the context of basic service reforms: the impact on caregiving environments in South Africa.

Adherence to treatment in poorer countries: a new research direction?