Beyond the socio-economic status: The concept of ‘vital poverty’

Poverty is today one of the greatest social problems in the world. In the document ‘Breaking the vicious cycle of mental ill-health and poverty’ (World Health Organization (WHO), 2007), the WHO has reported that: (1) mental disorders are about twice as frequent among the poorest. Depression is 1.5–2 times more prevalent among the low-income population; (2) people with low socio-economic status have a risk relative of schizophrenia eight times greater than those with high socio-economic status. Michael Marmot coined the expression ‘disease of poverty’ (Marmot, 2016) Wilkinson and Pickett (2018, ‘The inner level’) write that the actual increase in anxiety and stress is due to growing social inequalities. Dinesh Bhugra stressed that poverty affects mental illness through a series of variables such as physical and sexual abuse, psychological trauma, unwholesome lifestyles and the context in which one lives (Ventriglio & Bhugra, 2015). These studies insist mainly on a concept of material poverty.

The relationship between poverty and mental health complicates further if we consider that now we do not have a single definition of poverty.

Next to definitions based on strict income-based criteria, we hypothesize a new conceptualization of poverty based on qualitative parameters, such as cultural level or emotional heritage and values of each of us. The ‘vital poverty’ represents a new social determinant of mental health. It is a pivotal concept, linked to an impoverishment of values, relationships, culture and morals, in an independent way from economic and material conditions.

Lack of relationships, emotional poverty, meaninglessness, falling values, loss of the moral and religious sense are the indices of this new form of poverty that we have called ‘vital’ and constitute a risk factor, a substrate of psychopathological vulnerability (Siracusano, 2018; Siracusano & Ribolsi, 2018).

Anxiety, depression, adaptation disorders and some psychotic reactions can find in the poverty of life not a causal element but a psychopathological aggravation factor due to the conditions of general weakening of the resources of the individual.

The vital poverty is the substratum, the ground on which phenomena such as bullying arise.

Preliminary unpublished data collected on a transdiagnostic sample of 110 patients recruited at the psychiatric unit of the University Hospital Tor Vergata show an inverse correlation between resilience and vital poverty (R is –.519; p < .001). What is interesting to note is that the economic dimension of the scale alone does not correlate with resilience (R = –.162; p = .090) (Siracusano and Ribolsi, unpublished data). On the contrary, a significant correlation between vital poverty and general psychopathology was observed (R = .341; p < .001). These data are preliminary and should be verified in a larger sample of patients, with a greater number of potential variables that should be investigated in the analysis. Vital poverty was measured through a 16-item self-report questionnaire that investigates an economic dimension, a value dimension, an affective dimension and a relational dimension (Siracusano and Ribolsi, unpublished data).

The spread of bullying in our societies does not depend on the social status; indeed, episodes of bullying frequently occur in socially high contexts. We can hypothesize that the lack of remorse, the discrimination towards the other, the aggressiveness of bullying are linked to a subjective, relational and vital impoverishment. Other examples of vital poverty are femicide, the discrimination against migrants or minorities of all kinds, the spread of hate speech in the social networks.

The schools, universities and all the institutions committed to education are called to face vital poverty. It is not just a matter of material poverty.