Mental Illness and Stigma from a Socioeconomic Perspective

Background: The stigma associated with mental illness has a detrimental impact on a range of outcomes for those who experience it. Further to this, repeated attempts to address the health and social inequalities associated with mental illness have had limited success and these remain entrenched. Such patterns of marginalisation may be exacerbated by difficult economic circumstances. The thesis aims to explore the relationship between socioeconomic factors and the stigma associated with mental illness, with particular reference to the post-2007 recession context in the UK and Europe. Methods: A mixed methods approach was used incorporating three studies. Interviews with welfare claimants experiencing mental illness and an administrative data analysis investigated the impact of recent UK welfare reforms in relation to experiences of stigma and disadvantage. A cross-national European analysis explored the relationship between socioeconomic factors and attitudes towards people with mental illness. Findings: Interviewees (n=18) described feeling stigmatised, disempowered and financially disadvantaged by their experiences of the UK welfare system. Analysis of administrative data on claimants revealed that people with mental illnesses are around 2.40 (95% CI: 2.36, 2.44) times more likely to be considered ineligible for extra-cost disability payments than people with other health conditions following recent reforms. European data suggests that individual financial difficulties, greater income inequality and a higher disability poverty and social exclusion gap are key socioeconomic factors that associated with less tolerant attitudes towards people with mental illnesses. Conclusion: Taken together, the findings suggest that micro and macro level economic factors are implicated in stigma and can contribute to climates of tolerance or disadvantage for people with mental illnesses. Extending the parity of esteem agenda to other institutions such the welfare system may assist with addressing some of these inequalities, alongside greater recognition of the role of socioeconomic factors and power in perpetuating stigma and disadvantage

Budget 2021: a missed opportunity to make permanent the £20 increase to Universal Credit

Ruth Patrick, Kayleigh Garthwaite, Geoff Page, Maddy Power, and Katie Pybus comment on the government’s decision to extend the £20 uplift to Universal Credit by six months only. They argue that the increase should be a permanent one, as part of a broader commitment to reforming the social security system

The socioeconomic context of stigma: : examining the relationship between economic conditions and attitudes towards people with mental illness across European countries

Introduction: Efforts to reduce the stigma associated with mental illness have intensified over the past 30 years with a particular focus on improving public attitudes. Difficult economic circumstances can be harmful to intergroup relations, but little is known about whether there is a relationship between socioeconomic conditions and attitudes towards people with mental illnesses. Methods: Random effects logistic regression modelling was employed to explore the relationship between individual financial circumstances, contextual socioeconomic factors and difficulty speaking to a person with a significant mental illness across European countries. Results: Lower GDP per capita and higher income inequality at the country level, alongside individual financial difficulties, were each associated with a greater likelihood of reporting difficulty speaking to a person with a significant mental illness. Discussion: Micro and macro-economic factors are associated with public attitudes towards people with mental illness across Europe. With prolonged economic instability predicted over the coming years in Europe it is important that these findings are taken into consideration when designing mental health and social policies, in order to safeguard the progress that has been made in reducing mental health stigma to date

“The reality is that on Universal Credit I cannot provide the recommended amount of fresh fruit and vegetables per day for my children”: Moving from a behavioural to a systemic understanding of food practices

BACKGROUND: Evidence suggests that people living in poverty often experience inadequate nutrition with short and long-term health consequences. Whilst the diets of low-income households have been subject to scrutiny, there is limited evidence in the UK on the diet quality and food practices of households reporting food insecurity and food bank use. We explore lived experiences of food insecurity and underlying drivers of diet quality among low-income families, drawing upon two years of participatory research with families of primary school age children. METHODS: We report on a mixed-methods study of the relationship between low income, food bank use, food practices and consumption from a survey of 612 participants, including 136 free text responses and four focus groups with 22 participants. The research followed a parallel mixed-methods design: qualitative and quantitative data were collected separately, although both were informed by participatory work. Quantitative data were analysed using binary and multinomial logistic regression modelling; qualitative data were analysed thematically. RESULTS: Lower income households and those living with food insecurity struggle to afford a level of fruit and vegetable consumption that approaches public health guidance for maintaining a healthy diet, despite high awareness of the constituents of a healthy diet. Participants used multiple strategies to ensure as much fruit, vegetable and protein consumption as possible within financial constraints. The quantitative data suggested a relationship between higher processed food consumption and having used a food bank, independent of income and food security status. CONCLUSIONS: The findings suggest that individualised, behavioural accounts of food practices on a low-income misrepresent the reality for people living with poverty. Behavioural or educational interventions are therefore likely to be less effective in tackling food insecurity and poor nutrition among people on a low income; policies focusing on structural drivers, including poverty and geographical access to food, are needed

A Protective Monoclonal Antibody Targets a Site of Vulnerability on the Surface of Rift Valley Fever Virus

Summary: The Gn subcomponent of the Gn-Gc assembly that envelopes the human and animal pathogen, Rift Valley fever virus (RVFV), is a primary target of the neutralizing antibody response. To better understand the molecular basis for immune recognition, we raised a class of neutralizing monoclonal antibodies (nAbs) against RVFV Gn, which exhibited protective efficacy in a mouse infection model. Structural characterization revealed that these nAbs were directed to the membrane-distal domain of RVFV Gn and likely prevented virus entry into a host cell by blocking fusogenic rearrangements of the Gn-Gc lattice. Genome sequence analysis confirmed that this region of the RVFV Gn-Gc assembly was under selective pressure and constituted a site of vulnerability on the virion surface. These data provide a blueprint for the rational design of immunotherapeutics and vaccines capable of preventing RVFV infection and a model for understanding Ab-mediated neutralization of bunyaviruses more generally. : Allen et al. reveal a molecular basis of antibody-mediated neutralization of Rift Valley fever virus, an important human and animal pathogen. They isolate and demonstrate the protective efficacy of a monoclonal antibody in a murine model of virus infection, providing a blueprint for rational therapeutic and vaccine design. Keywords: phlebovirus, Rift Valley fever virus, antibody, structure, bunyavirus, virus-host interactions, immune response, vaccine, antiviral, neutralizatio