Mental health issues can considerably decrease an individual’s well-being, ability to work, be a functioning member of a community, and unsettle familial relationships. Some of these illnesses, depression, for instance, become major public health problems, as one of every three individuals experiences disruptions in mental health during their life (Vigo et al., 2016). Moreover, health conditions affecting emotions, ability to reason, or behavior contribute to increased morbidity and disability worldwide (Vigo et al., 2016). Consequently, the problem reduces global mental well-being, further deteriorated by stigma and social neglect that frequently accompany individuals with mental illnesses. This situation attracts researchers’ and scholars’ attention to various effects of mental health issues and methods to mitigate them. Thus, a significant body of literature relating to the subject emerged, accentuating the extent of the problem and its effects on individuals and societies at large.
Social Problems Associated With Mental Illness
Unemployment and Mental Health
Poor mental health and such a critical social problem as unemployment are seemingly two closely related notions. Since unemployment can vary from forced to voluntary, in this paper, it is principally viewed as an involuntary loss job (Myles et al., 2016). There are two main ways to describe relationships between the two notions. Firstly, unemployment can directly contribute to an individual’s worsening mental state and provoke symptoms of distress, anxiety, and depression (Australian Institute of Health and Welfare, 2018). Secondly, troubles with psychological health can create barriers to being employed, partially because mental illnesses are commonly stigmatized. It appears that these ideas are not mutually exclusive but propel each other. As a consequence, the impact of unemployment provoked by mental illness has economic, social, familial, and psychological manifestations. Involuntary job loss and inability to find another one, apart from financial adversities, can cause family tension, social isolation, shame, and housing stress.
The consequences of unemployment sometimes are fatal as a strong link between it and suicide exists. However, the loss of a job, in this case, possibly serves as a catalyst. According to Myles et al. (2016), “it seems that unemployment is likely to be causative of increased psychological distress, but eventual suicide is better explained by pre-existing mental illness” (p. 120). On the other hand, the relationships between employment, suicide, and mental health could be more complicated. A study among individuals admitted to psychiatric hospitals in Denmark concluded that suicidal ideation was less prominent in unemployed patients (Myles et al., 2016). This inconsistency can be explained by mental health stigmatization, as still employed patients additionally undergo the stress of future joblessness, damage to career, and loss of social prestige. In this way, unemployment can both cause additional psychological damage and prevent mentally ill individuals from suicide.
Job loss not only negatively impacts individuals with mental disorders but also people close to them. Spouses, parents, caregivers, and children frequently experience multiplying effects. Given that economic recessions are not extremely rare, the impact of unemployment on families seems to be well-documented. For example, growing divorce rates and reduced childbirth rates can be viewed as a result of one of the partners losing their job (Frasquilho et al., 2016). The added stress that financial hardship brings sometimes becomes a critical point in a marriage. Similarly, raising children necessitates a steady income, achieving which can be problematic for people with mental illness. Children’s decreased life satisfaction has been attributed to parental unemployment, undermining family life, which is reported to be less favorable (Frasquilho et al., 2016). Generally, unemployment is a considerable risk factor for psychological troubles both among the general population and people with mental illnesses that affect not only them but whole families.
Substance Abuse and Mental Health
Substance abuse is a social issue that puts a sizable strain on Australia’s public health care system. According to the Australian Institute of Health and Welfare (2018), “mental and substance use disorders contributed 12% of Australia’s total burden of disease in 2011” (p. 133). The problem contributes to increased crime rates, violence, financial troubles, and destitution – the social implications of substance abuse become a concern for entire communities. Furthermore, overconsumption of different drugs, including alcohol and tobacco, is one of the primary reasons for the development of diseases that otherwise might have been prevented. Although the relationships between mental illnesses and long-term, pathological use of addictive substances seem to be not thoroughly established, they often become comorbid conditions, especially in patients with schizophrenia and the homeless segment of the population (Khokhar et al., 2018). This social problem has detrimental consequences for individual and familial well-being.
In the case of individuals suffering from psychological troubles, substance abuse can undermine or prolong their therapy. Co-occurring substance abuse is connected to clinical aggravations, failure to comply with treatment, and higher relapse and hospitalization percentages – these complications lead to worse mental health outcomes (Khokhar et al., 2018). For instance, it is suggested that rates of drug addiction are “elevated (above that in the general population) in patients with psychotic, including those in their first psychotic episode” (Khokhar et al., 2018, p. 79). Priester et al. (2016) reach similar conclusions, stating that such individuals are especially vulnerable because addiction commonly aggravates the symptoms of their mental problems, establishes psychological unpredictability, and discourages from pursuing treatment. Individuals who have co-occurring mental health and substance use disorder are a numerous group – in the USA, almost nine million adults are diagnosed with it (Priester et al., 2016). More overarching effects of this social problem include loss of productivity and motivation, exacerbation of mental state, unemployability, health risks, reduced life quality, and others.
Substance abuse, specifically parental, destructively affects family relationships and health. Numerous studies corroborate the idea that children living with parents who have an addiction are more likely to develop mental health illnesses (Messina et al., 2015). The problem affects some children from a very early age and even prenatally, as their mothers continue substance abuse during pregnancy. Delayed psychological and physical developments are among numerous consequences – their extent depends on frequency, duration, and type of substance used (Messina et al., 2015). Henceforth, parental substance abuse jeopardizes a family’s safety, as children are often neglected, and their basic needs are left unsatisfied. At older ages, the consequences are represented by “poor language development, emotional problems (eg, social withdrawal, anxiety, and depression), and negative behavioral manifestations (eg, delinquency, aggressiveness, and pre-teen substance abuse)” (Messina et al., 2015, p. 16). To summarize, children are often the part of a family that extensively endures long- and short-term effects on their health and well-being by caregivers’ or parental’ substance abuse.
Nonetheless, child maltreatment and developmental problems are not only implications of the social issue under consideration. Partners and parents of individuals who have co-occurring substance use disorder can also be affected. In particular, intimate partner violence has been shown to have a clear linkage to substance abuse, mostly alcohol (Choenni et al., 2016). Moreover, child maltreatment and various domestic violence expressions frequently take place in parallel – research shows that from thirty to sixty percent of households where child abuse arises, other forms of family violence also coexist (Choenni et al., 2016). Adults suffering from the disorder and living with their parents or caregivers are equally prone to violent episodes that damage family relationships. It can be stated that this social problem possibly has an overarching harmful impact on all family members and individuals who suffer from an addiction as well, affecting their psychological state, deteriorating physiological condition, and the ability to function socially.
Health Promotion Strategies
Health Promotion and Unemployment
Unemployment can represent a risk for health, preventing individuals from accessing needed services. It seems to be a well-established notion that unemployed demographic has increased illness and mortality risks than employed demographic, since poverty is one of the main socioeconomic determinants of health (Myles et al., 2016). Loss of job possibly inflicts social and financial handicaps, ultimately causing long-term damage such as diminished life expectancy. Nutrition, living environment, and access to medical services are immediately affected by the social problem. In this case not only psychical, but also mental health tends to decline. The situation creates a necessity for preventive interventions and health promotion strategies directed at this endangered group.
Health promotion among the unemployed often benefits from various psychological treatments. For instance, cognitive-behavioral therapy forms a part of employment promotion for ameliorating psychological state and coping strategies for people out-of-work (Hollederer, 2018). According to Hollederer (2018), some studies show that the approach results in “statistically significant improvements in mental health, a reduction of anxiety and depression, higher self-esteem and higher self-efficacy in job searches” (p. 4). Jobfit is another strategy that strives to incorporate health promotion in job centers, occupational organizations, and programs. Health literacy counseling and disease prevention are merged in this approach. The health-oriented element of Jobfit has been shown to positively impact health behavior, particularly alimentation, physical activity, and use of several substances (Hollederer, 2018). Hence, the approach focuses on increasing employability in connection to jobseeker’s health, changing job search outcomes by impacting motivation and productivity.
Besides cognitive behavioral therapy and Jobfit, career health care services operate to promote health and social inclusion. This strategy was adopted, for example, in Finland to enhance the likelihood of employment and re-employment (Hollederer, 2018). Such career health care services specialize in health promotion and disease prevention, concentrating on issues like smoking cessation, excessive use of alcohol, healthy lifestyle promotion, and diet-related conditions (Hollederer, 2018). The program is claimed to achieve positive results since over half of its participants eventually became employed (Hollederer, 2018). Conclusively, cognitive behavioral therapy, career health care services, and Jobfit supposedly bring positive results regarding the interconnection of health and employability.
Health Promotion and Substance Use
Substance abuse is frequently viewed from the perspective of measuring and treating its negative consequences. Nevertheless, considering it from the standpoint of prevention sometimes may be more advantageous. Nurse-Family Partnership is a health promotion program that targets pregnant individuals and low-income mothers with substance abuse disorder (Messina et al., 2015). The program strives to prevent the effect of prenatal substance abuse on fetal development. Nurse‑Family Partnership offers regular nursing visits that start during the prenatal period – their principal mission is to promote positive health behavior among mothers (Messina et al., 2015). A randomized follow-up study revealed that children of mothers who participated in the program were less likely to experience psychological troubles such as anxiety and depression and be arrested later in life (Messina et al., 2015). Nurse-Family Partnership shows how health promotion can alleviate the impact of substance abuse on several generations.
Similarly to the outlined program, Focus on Families seeks to promote a healthier lifestyle positioning family as an essential healthcare unit. Although the program primarily revolves around methadone addiction treatment, it also incorporates social inclusion practices to improve communication and management skills. According to Messina et al. (2015), Parents under Pressure pursues similar goals to Focus on Families, teaching its participants “to gain greater control over their emotional state and reduce the likelihood that they will relapse to drug or alcohol use” (p. 18). Focus on Families, Parents under Pressure, and Nurse-Family Partnership represent family-focused comprehensive programs directed at either health promotion or social inclusion. The strategies employed view the family as a basis for diminishing substance abuse strain on public health.
Conclusion
Mental illnesses and psychological troubles become an increasingly grave problem in public health that entails such social issues as unemployment and substance abuse. The problems are strongly related to the potential decrease in mental health in the country, resulting from and propagating it. They tend to have multiple harmful effects on general physical and mental conditions. In order to counteract unemployment and substance abuse, numerous health promotion and social inclusions strategies and programs are developed. Given the impact that the social issues have on whole households, families often become the center of these programs.
References
Australian Institute of Health and Welfare. Australia’s health 2018. Australian Institute of Health and Welfare. Web.
Choenni, V., Hammink, A., & van de Mheen, D. (2016). Association between substance use and the perpetration of family violence in industrialized countries. Trauma, Violence, & Abuse, 18(1), 37–50.
Frasquilho, D., de Matos, M. G., Neville, F., Gaspar, T., & de Almeida, J. C. (2016). Parental unemployment and youth life satisfaction: The moderating roles of satisfaction with family life. Journal of Child and Family Studies, 25(11), 3214–3219.
Hollederer, A. (2018). Health promotion and prevention among the unemployed: A systematic review. Health Promotion International, 1-19.
Khokhar, J. Y., Dwiel, L. L., Henricks, A. M., Doucette, W. T., & Green, A. I. (2018). The link between schizophrenia and substance use disorder: A unifying hypothesis. Schizophrenia Research, 194, 78–85.
Messina, N., Calhoun, S., Conner, E., & Miller, M. (2015). Improving the outcomes of children affected by parental substance abuse: A review of randomized controlled trials. Substance Abuse and Rehabilitation, 15, 15–24.
Myles, N., Large, M., Myles, H., Adams, R., Liu, D., & Galletly, C. (2016). Australia’s economic transition, unemployment, suicide and mental health needs. Australian & New Zealand Journal of Psychiatry, 51(2), 119–123.
Priester, M. A., Browne, T., Iachini, A., Clone, S., DeHart, D., & Seay, K. D. (2016). Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment, 61, 47–59.
Vigo, D., Thornicroft, G., & Atun, R. (2016). Estimating the true global burden of mental illness. The Lancet Psychiatry, 3(2), 171–178.
Walker, E. R., & Druss, B. G. (2016). Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the U.S.A. Psychology, Health & Medicine, 22(6), 727–735.