Living in poverty with severe mental illness coping with double trouble

Abstract

Objectives: Several studies have pointed at a co-occurrence between severe mental problems and relative poverty. Also users refer to their strained financial situation as one of their main problems. We lack knowledge about how persons ‒ still characterised in diagnostic manuals as having difficulty with their sense of reality and their ability to carry out goal-oriented actions ‒ manage the ‘double trouble’ of having a strained financial situation and mental problems.

Method: Sixteen persons diagnosed with severe mental illness were interviewed about how they managed poverty in their everyday life. The interviews were tape-recorded and analysed using the thematic analysis method.

Results: The overarching theme that emerged was ‘managing a life on the margin’, with three sub-themes: ‘staying within limits’, ‘widening the boundaries’ and ‘indulging in the unnecessary’. The ways the interviewees coped with their strained financial situation are similar in many respects to those found in poverty research among people who do not have severe mental health problems

Conclusions and implication for practice: Professionals should strive to take the individual’s social context into consideration, both when examining each person and in practicing share decision-making. Adopting a contextual approach would help us to see the user as an agent and better understand the onset and development of severe mental problems. Phenomena considered as symptoms might then be better understood as rational coping with the reality of poverty.

Keywords:

• Community work
• exclusion/inclusion
• mental health
• therapeutic social work
• social welfare