Inequalities are all around us: poverty and financial strain, racism, sexism, bullying, abuse, neglect, homelessness and social exclusion due to sexual orientation, health, disability or age, to name just a handful.
Inequality even in the most developed countries is unfortunately higher today than it was 3 decades ago. Progress in developing economies has reduced inequality between nations to a degree, but the benefits within those countries are disproportionately spread for various reasons.
Unsurprisingly, concerns about inequality and its effects have become central in political arguments worldwide. Political actions, such as the “yellow vests” movement in France, Brexit and the election of anti-elitist, non-politically orientated leaders in Hungary, Italy, Poland, and the US all seem to have been inspired by these concerns. Most research agrees that we need a call-to-arms for governments to re-focus on the deep underlying drivers of inequality.
Income and wealth inequality increased in most of The Organization for Economic Cooperation and Development (OECD) countries between 1980 and the 2008 Global Financial Crisis, but unfortunately even in those countries where inequality did not increase, any gains have not been evenly distributed across the population.
Given the irrefutable proof that a range of social, economic, cultural and environmental drivers affect poor mental health, reducing the prevalence of mental health problems requires action that directly addresses these inequality factors.
The World Health Organization (WHO) has called for action to address social inequalities and “improve the conditions of daily life” throughout the life course in order to help improve the mental health of the population and reduce the risk of mental health problems because the costs of mental ill-health spreads well beyond the health sector.
Decreased mental health problems can help achieve strategic policy goals in other government departments and agencies because it is likely to result in lower costs in the criminal justice system and in workplaces, as fewer people with mental health problems will go to jail and work productivity could increase. It is also likely to improve educational outcomes, thus making the education system more effective and improving employability. Reducing illness and long-term incapacity due to mental health problems would also increase savings in social welfare benefits.
Government interventions in most countries are regrettably without driving force to implement policies that can bring about real change. Currently there is a massive strain on medical intervention and NGOs because inequality is not being address on national level and in legislation – there are 4 tiers of assistance that can impact and change inequality within countries but without provincial and national level assistance to support the individual (or company) and medical levels the result is a continuous need that grows instead of declines.
4 Tiers of Assistance
Measures to reduce inequalities in many countries remain overlooked and not prioritised on provincial and governmental level as seen in the 4 tiers of assistance.
CURRENT MEDICAL LEVEL (IMPERSONAL)
- Clinical specialist care (on referral)
- Suicide prevention for high-risk people
- Medical care
- Suicide crisis support (on request)
- Trauma Assistance (on request)
CURRENT INDIVIDUAL (COMPANY) LEVEL (PERSONAL)
(for example NGO’S & Social Workers)
- Empowerment programmes
- Resilience training
- Peer support groups
- Screening programmes
- Psychological therapies for children exposed to trauma
- Emotional literacy training
- Empowerment programmes for disadvantaged groups
- Debt advice
- Peer support groups
- Supports for parents with a mental health problem
COMMUNITY LEVEL (PROVINCIAL)
- Assessing community-level risk
- Measures to reduce inequalities
- Preventative interventions
- Trauma-informed approaches such as training for teachers and child-minders to assist children exposed to trauma
- Adequate Early Childhood Development (ECD) care
- Affordable housing
- Safe public spaces
- Community participation in prevention programs
- Improve school engagement & emotional literacy
- Trauma-informed public through programs and public forums
GOVERNMENT LEVEL (NATIONAL)
- Address and reduce economic inequalities fairly but forcefully
- Prevent ACEs, domestic/sexual violence & discrimination
- Create mentally healthy environments
- Map the socio-economic influences on mental health and address where needed
- Education on national level to identify and address abuse and discrimination
- Anti-domestic/sexual violence laws (enforced)
- Anti-discrimination laws (enforced)
- Address alcohol abuse and misuse – availability and licensing
- Reduced class sizes in school to enable teachers to give personal attention
- Regulation and stricter laws on marketing for harmful industries to reduce sexual abuse, human trafficking and pornography
Nationally, governments have not focused enough on policies that prevent inequality arising or worsening in the first place. Such policies often bring the added benefit of correcting other distortions that reduce the size of the economic pie but with the financial benefits going to the policy makers and industries that support or finance them there does not seem to be a drive to focus on and correct the inequality status that many cannot rise from.
In this light, the recent policy drives focusing on mediations for basic income, working hours and working conditions should be seen as too little. If these policy matters are still the focus after all these years and if the basic rights of people are not even adhered to when will focus be on on eliminating inequalities and improving quality of life in so many countries?
While organisations like HealingLeaves does all we can to not only assist individuals and families on community level with things such as food parcels, housing projects, skills training, job creation, financial support for learners, clothing schemes and supporting children who have suffered abuse, neglect and trauma, we need a call-to-arms for governments to re-focus on the deep underlying drivers of inequality whether ecological, physical, relational or economic in order to create fairer and more livable societies for all.
“As long as poverty, injustice and gross inequality persist in our world, none of us can truly rest.” – Nelson Mandela