Towards a grounded theory of the psychological impact of experiencing systemic barriers when attempting to overcome poverty. A qualitative study.

Research has long demonstrated the negative impact of living in poverty upon mental health. However, poverty remains a feature of people’s lives in the United Kingdom [UK] and the latest UK economic recession in 2008 added to the financial challenges of the country. As a result, the UK government introduced austerity measures attempting to stabilise the UK’s economy which included funding cuts to the welfare system and statutory services. This thesis aimed to investigate the impact of living in poverty upon psychological wellbeing. Chapter One presents a narrative literature review of quantitative and qualitative research reporting the psychological impact of poverty in the UK, since its latest recession in 2008. Thirteen of the fourteen reviewed papers demonstrated that there is a significant correlation between living in poverty and psychological distress. Chapter One also suggests that austerity measures are negatively impacting upon psychological wellbeing, especially for people living in existing poverty and those with mental health difficulties. Due to the levels of poverty in the area this research was conducted, voluntary services have developed projects to attempt to support people out of financial difficulty. However, individuals can face numerous barriers to accessing services such as these, and other services they need to access to overcome poverty. Therefore, Chapter Two presents an empirical Grounded Theory [GT] study investigating the psychological impact of experiencing systemic barriers when attempting to overcome poverty. A qualitative GT method was chosen to provide in-depth, rich data on the topic of interest given the lack of research on the impact of systemic barriers. Systemic barriers are barriers which are created, either directly or indirectly, through the way services are funded, set up and delivered. GT was also chosen to enable a theory to be developed from the data rather than existing theory guiding the research. The GT model which emerged found that there were four conceptual categories capturing participants experiences; ‘Accessibility, ‘Discrimination’, ‘Dehumanisation’ and ‘Resilient not Resigned’. Systemic barriers negatively impacted upon psychological wellbeing, triggering initial reactions of anger, anxiety, low mood and worthlessness. Participants described how these initial feelings could lead to secondary psychological reactions. Sometimes, they described secondary psychological reactions that, based on psychological theory, stemmed from initial psychological reactions without specifically mentioning the initial feeling. The secondary psychological reactions were: feelings of blame, shame, hopelessness, a loss of motivation, avoidance, a loss of trust in services, negatively impacting relationships, putting up barriers with others, a loss of confidence and a fear of future discrimination. Resilience and motivation were important for protecting participants from psychological harm and influenced levels of hope. Personal support networks provided external motivation for participants. It is unknown at which point these protective factors become salient for individuals. It may be that some participants were naturally more resilient and motivated, or these characteristics may have developed as coping strategies. There were also positive stories of experiencing positive feelings and prosocial behaviour following receiving appropriate support. There seems to be a vicious cycle in which poverty and mental health are linked, with mental health being both a vulnerability factor for poverty and poverty negatively affecting mental health. In addition, people can then face systemic barriers when attempting to access services to overcome poverty which further impacts upon their psychological wellbeing. Clinical implications are discussed in terms of reducing or eliminating systemic barriers to improve psychological wellbeing. Chapter Three is an executive summary of the empirical paper and was written for the participants and the project they were recruited from. Their feedback was sought via email