Mental health problems and socioeconomic disadvantage: a controlled household study in rural Ethiopia

 

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dc.contributor.author Hailemichael, Yohannes
dc.contributor.author Hanlon, Charlotte
dc.contributor.author Tirfessa, Kebede
dc.contributor.author Docrat, Sumaiyah
dc.contributor.author Alem, Atalay
dc.contributor.author Medhin, Girmay
dc.contributor.author Fekadu, Abebaw
dc.contributor.author Lund, Crick
dc.contributor.author Chisholm, Dan
dc.contributor.author Hailemariam, Damen
dc.date.accessioned 2019-12-10T09:11:25Z
dc.date.available 2019-12-10T09:11:25Z
dc.date.issued 2019-07-31
dc.identifier.citation International Journal for Equity in Health. 2019 Jul 31;18(1):121
dc.identifier.uri https://doi.org/10.1186/s12939-019-1020-4
dc.identifier.uri http://hdl.handle.net/11427/30689
dc.description.abstract Abstract Background There is a lack of high quality population-based studies from low- and middle-income countries examining the relative economic status of households with and without a member with a mental health problem. The aim of the study was to explore the socio-economic status of households with a person with severe mental disorder (SMD; psychosis or bipolar disorder) or depression compared to households without an affected person. Methods A population-based, comparative, cross-sectional household survey was conducted in Sodo district, south Ethiopia, between January and November 2015. Two samples were recruited, each with its own comparison group. Sample (1): households of 290 community-ascertained persons with a clinician-confirmed diagnosis of SMD and a comparison group of 289 households without a person with SMD. Sample (2): households of 128 people who attended the primary health care centre and who were identified by primary care staff as having a probable diagnosis of depressive disorder; and comparison households of 129 patients who attended for other reasons and who did not receive a diagnosis of depression. Household socioeconomic status (household income, consumption and asset-based wealth) was assessed using a contextualized version of theWorld Health Organization (WHO) Study on global Ageing and adult health (SAGE) questionnaire. Each disorder group (SMD and depression) was further divided into higher and lower disability groups on the basis of median score on the WHO Disability Assessment Schedule. Results Households of a person with SMD who had higher disability were more likely to have a poorer living standard (no toilet facility; p < 0.001). Having a reliable source of regular income was significantly lower in households of a person with SMD (p = 0.008) or depression (p = 0.046) with higher disability than the comparison group. Households of persons with SMD with higher disability earned less (p = 0.005) and owned significantly fewer assets (p < 0.001) than households without SMD. Households including persons with depression who had higher disability had lower income (p = 0.042) and reduced consumption (p = 0.048). Conclusions Households with a member who had either SMD or depression were socioeconomically disadvantaged compared to the general population. Moreover, higher disability was associated with worse socio-economic disadvantage. Prospective studies are needed to determine the direction of association. This study indicates a need to consider households of people with SMD or depression as a vulnerable group requiring economic support alongside access to evidence-based mental healthcare.
dc.subject Socio-economic status
dc.subject Severe mental disorder
dc.subject Depression
dc.title Mental health problems and socioeconomic disadvantage: a controlled household study in rural Ethiopia
dc.type Journal Article
dc.date.updated 2019-08-04T03:15:30Z
dc.language.rfc3066 en
dc.rights.holder The Author(s).
dc.identifier.apacitation Hailemichael, Y., Hanlon, C., Tirfessa, K., Docrat, S., Alem, A., Medhin, G., ... Hailemariam, D. (2019). Mental health problems and socioeconomic disadvantage: a controlled household study in rural Ethiopia. http://hdl.handle.net/11427/30689 en_ZA
dc.identifier.chicagocitation Hailemichael, Yohannes, Charlotte Hanlon, Kebede Tirfessa, Sumaiyah Docrat, Atalay Alem, Girmay Medhin, Abebaw Fekadu, Crick Lund, Dan Chisholm, and Damen Hailemariam "Mental health problems and socioeconomic disadvantage: a controlled household study in rural Ethiopia." (2019) http://hdl.handle.net/11427/30689 en_ZA
dc.identifier.vancouvercitation Hailemichael Y, Hanlon C, Tirfessa K, Docrat S, Alem A, Medhin G, et al. Mental health problems and socioeconomic disadvantage: a controlled household study in rural Ethiopia. 2019; http://hdl.handle.net/11427/30689. en_ZA
dc.identifier.ris TY - Journal Article AU - Hailemichael, Yohannes AU - Hanlon, Charlotte AU - Tirfessa, Kebede AU - Docrat, Sumaiyah AU - Alem, Atalay AU - Medhin, Girmay AU - Fekadu, Abebaw AU - Lund, Crick AU - Chisholm, Dan AU - Hailemariam, Damen AB - Abstract Background There is a lack of high quality population-based studies from low- and middle-income countries examining the relative economic status of households with and without a member with a mental health problem. The aim of the study was to explore the socio-economic status of households with a person with severe mental disorder (SMD; psychosis or bipolar disorder) or depression compared to households without an affected person. Methods A population-based, comparative, cross-sectional household survey was conducted in Sodo district, south Ethiopia, between January and November 2015. Two samples were recruited, each with its own comparison group. Sample (1): households of 290 community-ascertained persons with a clinician-confirmed diagnosis of SMD and a comparison group of 289 households without a person with SMD. Sample (2): households of 128 people who attended the primary health care centre and who were identified by primary care staff as having a probable diagnosis of depressive disorder; and comparison households of 129 patients who attended for other reasons and who did not receive a diagnosis of depression. Household socioeconomic status (household income, consumption and asset-based wealth) was assessed using a contextualized version of theWorld Health Organization (WHO) Study on global Ageing and adult health (SAGE) questionnaire. Each disorder group (SMD and depression) was further divided into higher and lower disability groups on the basis of median score on the WHO Disability Assessment Schedule. Results Households of a person with SMD who had higher disability were more likely to have a poorer living standard (no toilet facility; p < 0.001). Having a reliable source of regular income was significantly lower in households of a person with SMD (p = 0.008) or depression (p = 0.046) with higher disability than the comparison group. Households of persons with SMD with higher disability earned less (p = 0.005) and owned significantly fewer assets (p < 0.001) than households without SMD. Households including persons with depression who had higher disability had lower income (p = 0.042) and reduced consumption (p = 0.048). Conclusions Households with a member who had either SMD or depression were socioeconomically disadvantaged compared to the general population. Moreover, higher disability was associated with worse socio-economic disadvantage. Prospective studies are needed to determine the direction of association. This study indicates a need to consider households of people with SMD or depression as a vulnerable group requiring economic support alongside access to evidence-based mental healthcare. DA - 2019-07-31 DB - OpenUCT DP - University of Cape Town KW - Socio-economic status KW - Severe mental disorder KW - Depression LK - https://open.uct.ac.za PY - 2019 T1 - Mental health problems and socioeconomic disadvantage: a controlled household study in rural Ethiopia TI - Mental health problems and socioeconomic disadvantage: a controlled household study in rural Ethiopia UR - http://hdl.handle.net/11427/30689 ER - en_ZA


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