Lesson 9: Community Mental Health Problems: Environment


Attention

"We earn a living by what we make, we make a life by what we give."

Sir Winston Churchill

Relative poverty. Absolute poverty.

Homelessness.

Hunger. Mental Illness.

They all intersect and affect community mental health.


Learning Outcomes

Upon completion of this lesson's material, students will be able to:

  • Discuss the effects of poverty, discrimination, and homelessness on mental health.
  • Explain how noise "pollution" can lead to mental illness.
  • Discuss the effects of road rage on mental health.
  • Analyze the role of mental health professional working with the homeless.
  • Analyze the link between poverty and mental illness.

Teaching

We are currently living in an environment that results in us being exposed to all different types of chemicals in our everyday lives. As we introduce additional chemcals into our daily lives we can not be sure what the short and long term impact of that exposure will be. It is easy for us to forget that even though we are humans and currently living at the top of the food chain we are still biological creatures that can be affected in the short and long term by the environment around us.

Watch the film called Death by a Thousand Cuts (Homo-Toxicus) (https://www.youtube.com/watch?v=M3w8bgaQpSE) (length 43:25 min).

This is a detailed documentary on the chemical toxic exposure that impact on physical, sensory-perceptual, and potentially mental health.

I found this YouTube video on The Influence of Environment on Mental Health (https://www.youtube.com/watch?v=poW7EFQ1LkM) (length 14:13 min).

As we continue to think ourselves as mammals on earth it can helpful to see how some of our biological functions have changed over time. The onset of the first mentrual cycle for women has been occurring earlier and earlier over the past 200 years. The food chain consumed by humans, both in terms of quantity and quality, may by at the heart of this. Body mass/fat ratio drives onset of puberty for females. The resultant changing hormone levels affect behavior, identity and body-image. The artificial speeding up of this otherwise naturally occurring event my not be what nature intended. Earlier onset for fertility can result in earlier pregnancy, childbirth, and the cascade of responsibilities that this entails. Under-prepared parents-to-be, and societal response to young pregnancy, can start the cycle of poverty and adjustment disorder(s). The United States DOES NOT have the best rates for infant survival during the first year of life. On a scale of just thirty countries from best to worst, the U.S. hovers at about 17th down the scale. Premature babies, and low birthweight babies drive infant mortality. The infant mortality rate (IMR) is the number of deaths of infants under one year old per 1,000 live births. The table below represents the number of deaths of infants under one year old per 1,000 live births by country, 2013 (source: Child Mortality Estimates). So you can see that the United States is a medium green color, this represents 5 - 10 infant deaths per 1,000 live births. So in the Africian country of Angolia (a chocolate brown color in south west Africa) has 100 - 110 infant deaths per 1,000 live births.

Poverty and Homelessness

Some other significant environmental factors include poverty and homelessness.

Have you ever contemplated living without a "fixed" residence? Living from day-to-day, never knowing where you will have shelter and safety is VERY stressfull. Maslow's hierarchy of needs identifies basic, fundamental needs, then on to higher, meaning needs. Food, shelter, clothing are fundamental.

Click HERE to visit the National Alliance to End Homelessness website.

This article shares 10 Facts About Homelessness (Quigley, B. (2013) 10 Facts about homelessness. Retrieved from http://www.huffingtonpost.com/bill-quigley/ten-facts-about-homelessn_b_5977946.html). I am hopeful that this article helped you to appreciate the risk factors a person's environment, any type of abuse abuse, mental illness, and addiction play in the rates of homelessness.

Story from Professor Goodstat: A few years ago, a student of mine at KVCC told me that she was going to go on a weeked mission with her church to Boston, Massachusetts, to work with the homeless in a certain part of the city. She asked me what to expect. I asked her to come back and tell me what occurred. When I next saw her, she didn't look quite right. She reported that it was the worst thing she had ever seen. Nothing would have prepared her for what she witnessed. I told her that what she saw continues after she returned to Maine!! She was devastated by the outreach for the weekend. Imagine, in cities with truly vast wealth, name any large city you wish, there are people who from day to day, have no food, no water, no shelter, no medical care, and, on, and on. This is real. It exists all over the world. The estimate is that something like 70% of the homeless are mentally ill. The illness routinely is NOT believed to be caused by homelessness but that mental illness can give rise to the cycle of poverty, homelessness, and at risk activities.

Mental health treatment, return to community and oftentimes relapse does not always break the cycle of poverty and homelessness. Everyone, at least in terms of intention, wants to help those in need but the reality is that the core problems are chronic and systemic. Mental illness frighthens most people not trained to understanding anything about cause and effect of mental health issues.

One example of this broad level of fear and misunderstanding is the "Not in my Backyard" mentality. If a mental health agency wants to establish a group home or supported living environment for individuals who have mental health issues, struggled with homelessness, struggled with addiction or are disabled the agency may encounter individuals who do not want the facility in their town, in their neighborhood, on their block or in their backyard. It is our role as mental health professionals to help advocate for individuals in their communities and home enviroments to reduce the incidence of discrimination due to their mental health histories. Without a sense that we are all our brothers' keepers, it doesn't work. Without a sense community, there cannot be community mental health.

The expression, that you are two rent failures away from homelessness is not an idle comment. Two failed mortgage payments can result in the same outcome. Subprime mortgage loans (are adjustable rate mortgages and were generally a loan offered to prospective borrowers with impaired credit records) were at the heart of the economic melt-down that hit the financial sector in 2008. It is now 6 years later. What markers for recovery do you see? The partial government shutdown for 16 days on October 2013, affected Professor Goodstat and his wife. It also affected some 800,000 federal employees. Many individuals experienced lost payroll, although made whole after the shutdown, totalled 1 billion dollars. What you may not know however, is that an additional 23 billion dollars was wasted on non-recovered expenses for travel, lodging, and meals for government business that had been paid in advance!!! No refunds there.

Follow-the-dollar. A very crude expression. However, transparency and accountability can only happen if we understand how things are funded and what the priorities are in the first instance. We have a vast disparity socio-economically in the world at large. We also have enormous day-to-day survival challenges to over half the world's population. That is three and one-half billion people, 65 % of which are CHILDREN. It is hard to stop thinking about these issues. There is great pain and suffering out there. What will your role be in assisting individuals whose environment has affected their current situation?


Assessment

Lesson 9 Quiz

  1. Read the local newspaper or search the Internet to find an article about homelessness in Maine. Provide a link for the article, summarize the article and share your thoughts about the perspective the article shared.
  2. What current environmental issue in your community, in the US, or in the world do you worry the most about? Why? What can you do to reduce the impact of this environmental issue?

Lesson 9 Discussion (for the online course only)

Identify persons in your community who work with the homeless population. This may require a phone call or an email. Ask them to identify gaps in services. How would/could you address these gaps as a current or future mental health worker?