Poverty's Effect on Mental Health

Apathy among the young is significant as illustrated by Gerardo’s outlook. Domestic violence and sexual abuse wreak havoc in these families.

Education for All

Many focus on formal education of youth as a means of curbing poverty, but the picture is complex. Chaotic family life erodes early brain development.

Neurobiologists find that stress and trauma impinge on development of executive function and impulse control. With these deficits, children fail at school, and a cycle of failure ensues. Evidence suggests that the poorest children do worse as students.

Journalist Paul Tough, the author of "How Children Succeed: Grit, Curiosity, and the Hidden Power of Character" (New York: Houghton Mifflin Harcourt, 2012), studied poor families in Chicago and the ways in which children grow up in poverty.

He emphasizes that youngsters in stressful homes are not able to develop normally. Character traits such as perseverance, grit, self-discipline, and the ability to conquer adversity are survival skills. They get fostered in mentoring programs geared for inner-city youth.

There already are isolated community-based projects such as the Harlem Children’s Zone, which have raised awareness of education’s value and the need for family involvement. Unfortunately, funding for such projects remains scarce.

Young people such as Gerardo are channeling their grit – despite cynicism – into an education. Others in similar circumstances commit crimes and cause us to wonder whether they lack humanity. They live on "the edge of the law, the edge of the economy, the edge of family structure and communities," according to then Sen. Barack Obama in his speech at Hampton University in 2007. Depression, posttraumatic stress disorder, and character disorders abound in this population.

Remedies Through Education

Education is cited as the first step in curbing poverty. Learning leads to awareness and the acquisition of marketable skills. But education is a family matter. It should extend to the parents of children at risk. Adults need to know that their children require peace and safety to get homework done and to thrive. Working, devoted parents are role models. The way in which parents eat determines what children consume.

I see in my practice parents whose misconceptions prevent their children from benefiting from learning opportunities. Tutoring is available in public schools but overwhelm parents who say their child’s teacher never advised it. The same reasoning applies to summer school and sponsored summer camps such as the Fresh Air Fund. Sometimes parents fear after-school activities or church groups because they hear of incidents of child abuse on the news. Instead, children languish in front of a TV or play video games; they fall behind academically after inactive summers.

Parent education can make the adults advocates. It should be broadly available in schools and social service agencies. If adults become knowledgeable and improve their judgment, the needs of youngsters will be met.

This is where we psychiatrists have a role. As mental health professionals, we can help parents change their behaviors. We also can work with young people such as Gerardo so that they are able to come to terms with their circumstances and go on to lead prosperous and fulfilling lives. Education and mental health services can help patients overcome poverty.

Dr. Cohen is in private practice in New York. She consults at New York Presbyterian Hospital-Cornell and at the Hospital for Special Surgery.