Mental illness, poverty and stigma in India: a case-control study

Area of Science:

• Social Psychiatry
• Public Health
• Poverty Studies

Background:

• Severe mental illness (SMI) is often associated with socioeconomic disadvantages.
• Stigma experienced by persons with severe mental illness (PSMI) can exacerbate poverty.
• Understanding the multidimensional aspects of poverty is crucial for effective interventions.

Purpose of the Study:

• To investigate the relationship between experienced stigma and the depth of multidimensional poverty among PSMI in Delhi, India.
• To control for demographic factors such as gender, age, and caste in this assessment.
• To identify key contributors to poverty among PSMI.

Main Methods:

• A case-control study design was employed, matching hospital cases (PSMI) with population controls.
• 647 PSMI diagnosed with schizophrenia or affective disorders were recruited and matched with 647 controls.
• Data collection occurred from November 2011 to June 2012 in Delhi, India.

Main Results:

• 38.5% of PSMI experienced multidimensional poverty compared to 22.2% of controls.
• Multidimensional poverty was significantly associated with stigma (OR 2.60), belonging to scheduled castes/tribes/other backward castes (OR 2.39), mental illness (OR 2.07), and female gender (OR 1.87).
• A significant interaction revealed that female PSMI and PSMI from lower castes were disproportionately poorer due to stigma.

Conclusions:

• Public stigma and multidimensional poverty are deeply interconnected for individuals with SMI.
• Stigma is a potent predictor of poverty, particularly for women and individuals from lower castes.
• Exclusion from employment and lack of income are primary drivers of poverty for PSMI, necessitating awareness and action from mental health professionals.