The impact of poverty on mental health and well-being and the necessity for integrated social policies in Romania

On almost every account people with mental health problems are among the most excluded groups in society and they consistently identify stigmatisation, discrimination and exclusion as major barriers to health, welfare and quality of life. The links between poverty and ill health are well known. Poverty and illness together make people much more vulnerable and needy at all stages of their lives, and even more so in old age. Mental health is often both a cause and a consequence of poverty, compromised education, vulnerability, difficulty accessing housing, health care and employment, and lack of access to welfare, social security, and community public services. Inequalities between social classes in the incidence of chronic illness and mental illness and in life expectancy are also well documented. The working class poor with health problems are a particularly vulnerable group. Moreover people with mental health problems are more likely to experience physical health problems, which can further compromise the efforts of the individual in an already disadvantaged situation. When the experience of mental illness is the cause or a factor in the experience of exclusion, the effects can be still more damaging. This mutual interaction linking mental health and development can work positively with good mental health facilitating the active and successful involvement of individuals and communities in development, and negatively with poor mental health increasing the risk of descending into a vicious cycle of poverty and adverse social and health outcomes. Designing social policies and interventions - both within and outside the health sector - which strengthen social inclusion, represent a key action recommended by the European Pact for Mental Health and Wellbeing. This paper explores the situation of persons affected by severe mental illness on regional level in Romania. The need for policy development and improvement strategies are also highlighted.