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Poverty transitions in severe mental illness: longitudinal analysis of social drift in China, 1994–2015

Published online by Cambridge University Press:  23 February 2021

Yue-Hui Yu ,
Wei Luo ,
Bo Liu ,
Wei-Hong Kuang ,
Larry Davidson ,
Cecilia Lai Wan Chan ,
Lin Lu ,
Meng-Ze Xiang  and
Mao-Sheng Ran Open the ORCID record for Mao-Sheng Ran [Opens in a new window]
Yue-Hui Yu
Affiliation:
School of Public Administration and Policy, Renmin University of China, Beijing 100872, China
Wei Luo
Affiliation:
Chengdu Xinjin Second People's Hospital, Xinjin, Chengdu 611432, China
Bo Liu
Affiliation:
Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
Wei-Hong Kuang
Affiliation:
Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China
Larry Davidson
Affiliation:
Yale University, School, New Haven, CT, USA
Cecilia Lai Wan Chan
Affiliation:
Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
Lin Lu
Affiliation:
Peking University Sixth Hospital, Institute of Mental Health, Peking University, Beijing 100191, China
Meng-Ze Xiang
Affiliation:
Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China
Mao-Sheng Ran*
Affiliation:
Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
*
Author for correspondence: Mao-Sheng Ran, E-mail: msran@hku.hk
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Abstract

Background

Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China.

Methods

Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions.

Results

The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty.

Conclusions

This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.

Keywords

Chinapoverty transitionssevere mental illnesssocial drift
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 15 , November 2022 , pp. 3597 - 3605
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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References

Addison, T., Hulme, D., & Kanbur, R. (2008). Poverty dynamics: Measurement and understanding from an interdisciplinary perspective. Brooks World Poverty Institute (BWPI) Working Paper, 19, 1–23.Google Scholar
Anakwenze, U., & Zuberi, D. (2013). Mental health and poverty in the inner city. Health & Social Work, 38(3), 147–157.CrossRefGoogle ScholarPubMed
Barr, B., Taylor-Robinson, D., Stuckler, D., Loopstra, R., Reeves, A., & Whitehead, M. (2016). ‘First, do no harm’: Are disability assessments associated with adverse trends in mental health? A longitudinal ecological study. Epidemiology and Community Health, 70(4), 339–345.CrossRefGoogle ScholarPubMed
Breslau, J., Lane, M., Sampson, N., & Kessler, R. C. (2008). Mental disorders and subsequent educational attainment in a US national sample. Journal of Psychiatric Research, 42(9), 708–716.CrossRefGoogle Scholar
Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social Clinical Psychology Review, 25(8), 875–884.CrossRefGoogle Scholar
De Hert, M., Correll, C. U., Bobes, J., Cetkovich-Bakmas, M., Cohen, D., Asai, I., … Ndetei, D. M. (2011). Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry, 10(1), 52.CrossRefGoogle ScholarPubMed
Dercon, S., Hoddinott, J., & Woldehanna, T. (2012). Growth and chronic poverty: Evidence from rural communities in Ethiopia. Journal of Development Studies, 48(2), 238–253.CrossRefGoogle Scholar
Ehrlich, C., Kendall, E., Frey, N., Kisely, S., Crowe, E., & Crompton, D. (2014). Improving the physical health of people with severe mental illness: Boundaries of care provision. International Journal of Mental Health Nursing, 23(3), 243–251.CrossRefGoogle ScholarPubMed
Gao, Q., & Zhai, F. (2012). Anti-poverty family policies in China: A critical evaluation. Asian Social Work and Policy Review, 6(2), 122–135.CrossRefGoogle Scholar
Grosh, M., & Glewwe, P.. (2000). Designing Household Survey Questionnaires for Developing Countries (Vol. 3). Washington, DC: World Bank Publications.Google Scholar
Harding, C. M., Brooks, G. W., Ashikaga, T., Strauss, J. S., & Breier, A. (1987). The Vermont longitudinal study of persons with severe mental illness, I: Methodology, study sample, and overall status 32 years later. American Journal of Psychiatry, 144(6), 718–726.Google ScholarPubMed
Huang, Y., Wang, Y., Wang, H., Liu, Z., Yu, X., Yan, J., … Lu, J. (2019). Prevalence of mental disorders in China: A cross-sectional epidemiological study. The Lancet Psychiatry, 6(3), 211–224.CrossRefGoogle Scholar
Hudson, C. G. (2005). Socioeconomic status and mental illness: Tests of the social causation and selection hypotheses. American Journal of Orthopsychiatry, 75(1), 3–18.CrossRefGoogle ScholarPubMed
Hulme, D., Moore, K., & Shepherd, A. (2001). Chronic poverty: Meanings and analytical frameworks. Chronic Poverty Research Centre (CPRC) Working Paper, 2, 1–41.Google Scholar
Iniguez-Montiel, A. J. (2014). Growth with equity for the development of Mexico: Poverty, inequality, and economic growth (1992–2008). World Development, 59, 313–326.CrossRefGoogle Scholar
Kimberlin, S., & Berrick, J. D. (2015). Poor for how long? Chronic versus transient child poverty in the United States. In Fernandez, E., Zeira, A., Vecchiato, T., & Canali, C. (Eds.), Theoretical and Empirical Insights into Child and Family Poverty, (Vol. 10, pp. 141–158). Cham: Springer.CrossRefGoogle Scholar
Lawson, D., McKay, A., & Okidi, J. (2006). Poverty persistence and transitions in Uganda: A combined qualitative and quantitative analysis. The Journal of Development Studies, 42(7), 1225–1251.CrossRefGoogle Scholar
Li, L., & Bai, X. M. (2010). Measurement and decomposition of China's urban and rural household poverty vulnerability: An empirical study based on CHNS. Quantitative Economics and Technical Economics Research, 8, 61–73.Google Scholar
Li, N., Pang, L. H., Du, W., Chen, G., & Zheng, X. Y. (2012). Association between poverty and psychiatric disability among Chinese population aged 15–64 years. Psychiatry Research, 200(2–3), 917–920.CrossRefGoogle ScholarPubMed
Li, Y. H., Su, B. Z., & Liu, Y. S. (2016). Realizing targeted poverty alleviation in China: People's voices, implementation challenges and policy implications. China Agricultural Economic Review, 8(3), 443–454.CrossRefGoogle Scholar
Liu, L. C. (2015). Difference analysis for Chinese poor families, a study based on ‘social policy supporting system for rural and urban poor families’ project. Journal of Gansu Theory, 2, 86–91.Google Scholar
Liu, T. L., Zhang, L., Pang, L. H., Li, N., Chen, G., & Zheng, X. Y. (2015). Schizophrenia-related disability in China: Prevalence, gender, and geographic location. Psychiatric Services, 66(3), 249–257.CrossRefGoogle ScholarPubMed
Lund, C., Breen, A., Flisher, A. J., Kakuma, R., Corrigall, J., Joska, J. A., … Patel, V. (2010). Poverty and common mental disorders in low and middle income countries: A systematic review. Social Science & Medicine, 71(3), 517–528.CrossRefGoogle ScholarPubMed
Lund, C., De Silva, M., Plagerson, S., Cooper, S., Chisholm, D., Das, J., … Patel, V. (2011). Poverty and mental disorders: Breaking the cycle in low-income and middle-income countries. The Lancet, 378(9801), 1502–1514.CrossRefGoogle ScholarPubMed
Mezuk, B., Edwards, L., Lohman, M., Choi, M., & Lapane, K. (2012). Depression and frailty in later life: A synthetic review. International Journal of Geriatric Psychiatry, 27(9), 879–892.CrossRefGoogle ScholarPubMed
Mitra, S., Posarac, A., & Vick, B. (2013). Disability and poverty in developing countries: A multidimensional study. World Development, 41, 1–18.CrossRefGoogle Scholar
Ngui, A. N., Cohen, A. A., Courteau, J., Lesage, A., Fleury, M.-J., Gregoire, J.-P., … Vanasse, A. (2013). Does elapsed time between first diagnosis of schizophrenia and migration between health territories vary by place of residence? A survival analysis approach. Health & Place, 20, 66–74.CrossRefGoogle Scholar
Norton, S. W. (2002). Economic growth and poverty: In search of trickle-down. Cato Journal, 22, 263.Google Scholar
Patel, V., Araya, R., Chatterjee, S., Chisholm, D., Cohen, A., De Silva, M., … Van Ommeren, M. (2007). Treatment and prevention of mental disorders in low-income and middle-income countries. The Lancet, 370(9591), 991–1005.CrossRefGoogle ScholarPubMed
Patel, V., Xiao, S., Chen, H., Hanna, F., Jotheeswaran, A., Luo, D., … Yu, Y. (2016). The magnitude of and health system responses to the mental health treatment gap in adults in India and China. The Lancet, 388(10063), 3074–3084.CrossRefGoogle Scholar
Perese, E. F. (2007). Stigma, poverty, and victimization: Roadblocks to recovery for individuals with severe mental illness. Journal of the American Psychiatric Nurses Association, 13(5), 285–295.CrossRefGoogle Scholar
Rahman, M. A. (2013). Household characteristics and poverty: A logistic regression analysis. Journal of Developing Areas, 47(1), 303–317.CrossRefGoogle Scholar
Ran, M. S., Chan, C. L. W., Ng, S. M., Guo, L. T., & Xiang, M. Z. (2015). The effectiveness of psychoeducational family intervention for patients with schizophrenia in a 14-year follow-up study in a Chinese rural area. Psychological Medicine, 45(10), 2197–2204.CrossRefGoogle Scholar
Ran, M. S., Weng, X., Liu, Y. J., Zhang, T. M., Yu, Y. H., Peng, M. M., … Xiang, M. Z. (2019). Change of treatment status of persons with severe mental illness in a rural China, 1994–2015. BJPsuch Open, 5(e31), 1–7.Google Scholar
Ran, M. S., Xiao, Y., Fazel, S., Lee, Y., Luo, W., Hu, S. H., … Chan, C. L. W. (2020). Mortality and suicide in schizophrenia: 21-year follow-up in rural China. BJPsych Open, 6(e121), 1–8.CrossRefGoogle ScholarPubMed
Ran, M. S., Yu, Y. H., Peng, M. M., Liu, Y. J., Zhang, T. M., Hu, S. H., … Luo, W. (2018). Poverty and outcomes of people with severe mental disorders in rural China: A 21-year survey. The Lancet, 392, S7.CrossRefGoogle Scholar
Richter, D., & Hoffmann, H. (2019). Social exclusion of people with severe mental illness in Switzerland: Results from the Swiss health survey. Epidemiology and Psychiatric Sciences, 28(4), 427.CrossRefGoogle ScholarPubMed
Saraceno, B., Levav, I., & Kohn, R. (2005). The public mental health significance of research on socio-economic factors in schizophrenia and major depression. World Psychiatry, 4(3), 181.Google ScholarPubMed
Schwittay, A., Badiane, K., & Berdish, D. (2011). The marketization of poverty. Current Anthropology, 52(S3), 000–000.CrossRefGoogle Scholar
She, P., & Livermore, G. A. (2009). Long-term poverty and disability among working-age adults. Journal of Disability Policy Studies, 19(4), 244–256.Google Scholar
Song, B. A., & Liu, J. J. (2015). Constructing social security and social welfare for different groups (panel): Living context of rural mental disabled persons and policy recommendation. Heilongjiang Academy of Social Science, 5, 82–87.Google Scholar
Trani, J.-F., Bakhshi, P., Kuhlberg, J., Narayanan, S. S., Venkataraman, H., Mishra, N. N., … Deshpande, S. (2015). Mental illness, poverty and stigma in India: A case–control study. BMJ Open, 5(2), e006355.CrossRefGoogle ScholarPubMed
Tse, S., Ran, M.-S., Huang, Y., & Zhu, S. (2013). Mental health care reforms in Asia: The urgency of now: Building a recovery-oriented, community mental health service in China. Psychiatric Services, 64(7), 613–616.CrossRefGoogle ScholarPubMed
Wang, S. (2008). Combating poverty in development: A summary and evaluation of China's mass poverty reduction in past 30 years. Management World, 11, 78–88.Google Scholar
Wilton, R. (2004). Putting policy into practice? Poverty and people with serious mental illness. Social Science & Medicine, 58(1), 25–39.CrossRefGoogle ScholarPubMed
Xiong, N., Yang, L., Yu, Y., Hou, J., Li, J., Li, Y., … Jiao, Z. (2011). Investigation of raising burden of children with autism, physical disability and mental disability in China. Research in Developmental Disabilities, 32(1), 306–311.CrossRefGoogle ScholarPubMed
Ye, X. Q., & Yin, H. D. (2019). From eradicating absolute poverty to alleviate relative poverty: The course of poverty alleviation and its new strategies after 2020. Reform, 12, 5–15.Google Scholar
Yu, Y., Luo, W., He, M. X., Yang, X., Liu, B., Guo, Y., … Ran, M. S. (2020b). Household poverty in people with severe mental illness in rural China: 1994–2015. BJPsych Open, 6(e111), 1–8.CrossRefGoogle ScholarPubMed
Yu, Y. H., Peng, M. M., Bai, X., Luo, W., Yang, X., Li, J., … Ran, M. S. (2020a). Schizophrenia, social support, caregiving burden and household poverty in rural China. Social Psychiatry and Psychiatric Epidemiology, 55, 1571–1580.CrossRefGoogle ScholarPubMed
Yu, Y. H., & Ran, M. S. (2019). Community mental health services in the course of social development in China. Social Construction, 5, 19–25.Google Scholar
Zhang, T.-M., Wong, I. Y.-L., Yu, Y.-H., Ni, S.-G., He, X.-S., Bacon-Shone, J., … Ran, M.S., (2018). An integrative model of internalized stigma and recovery-related outcomes among people diagnosed with schizophrenia in rural China. Social Psychiatry & Psychiatric Epidemiology, 54, 911–918.CrossRefGoogle ScholarPubMed
Zhou, Y., Zhou, R., Li, W., Lin, Y., Yao, J., Chen, J., & Shen, T. (2015). Controlled trial of the effectiveness of community rehabilitation for patients with schizophrenia in Shanghai, China. Shanghai Archives of Psychiatry, 27(3), 167–174. doi: 10.11919/j.issn.1002-0829.215026Google ScholarPubMed