Health inequalities and austerity in Stockton-on-Tees

Stress and mental health: narratives of mothers in Stockton

  

Amy Greer Murphy

Department of Geography

28/06/2016

Brief overview of my topic: ‘Austerity, health inequalities and mothers in Stockton-on-Tees’.

• Second year PhD student at Dept. of Geography.• Women's experiences of austerity: health and wellbeing,

service use and access, income and benefit receipt, housing, employment, coping mechanisms.

• Ethnography with women's group based in the town centre as well as in-depth longitudinal qualitative interviews with 15 mothers.

• Stage: finishing fieldwork, qualitative analysis.• Engaging with diverse sample of mothers from across

the borough to emphasise the spatial and gendered nature of inequalities.

Local Health in an Age of Austerity: The Stockton-on-Tees study

dur.ac.uk/ health.inequalities

Why Stockton?

Research methods: Ethnography• Ethnography means ‘writing

about people’ and it is both a process (ethnographic research) and a product (an ethnography).

• Ethnographic research involves participating in, and observing and reflecting upon, people’s lives and social contexts.

• It is a research method that derives data from the in-depth, long-term study of a specific social world.

Methods: Qualitative Longitudinal Interviewing

• Longitudinal Research is used across disciplines. Investigating and interpreting how dynamic social processes shape us.

• Can produce in-depth data illustrating how cultural, geographical and historical processes interact to produce outcomes and how individuals respond to and engage with change (Holland et al., 2006).

• Consists of repeat semi-structured interviews with 15 women.

Stress, gender and health inequalities• Health inequalities generally refers to the systematic

differences in the health of people occupying unequal positions in society (Graham, 2009).

• Women have lower rates of mortality but report higher levels of depression, psychiatric disorders, distress, and a variety of chronic illnesses than men (McDonough & Walters, 2001; Verbrugge, 1985).

• An intersectional approach to health inequalities allows us to understand how gender, race, age, sexuality and other aspects of identity interact. Intersectionality offers a useful framework, it recognises individuals have multiple aspects to their identity, influencing their relationships with others and structures of power, and their health (Hill, 2016).

Stress, gender and health inequalities

Denton et al. (2004) argue that ‘levels of health are determined by social structures of inequality, differences in health related behaviours and psychosocial factors including stressful life events, chronic stressors and psychological resources. But the picture is more complex than that….[these] factors are rooted in the social structures of inequality that define people’s lives’.

The next section will introduce the stories of three women from the study to highlight some of the difficulties mothers on low income face in dealing with intersecting inequalities.

Chloe

• 25-34.• Two young sons, both with autism diagnosis.• Recently became a single parent, is Carer for her

children.• Volunteers at local charity and involved in local politics.

[On coping with post-natal depression]

‘My son came along in 2009, and it was probably one of the worst times of my life. I had post-natal depression after him, for about 6 months before I got any help. And the doctor asked if I had any support. I said my mum, but she’s caring for my dad, he had just finished his chemotherapy at that time but we knew he wasn’t going to get better.

The doctor said ‘well you’re lucky, you’ve got more than a lot of people have’ and sent me away. No medication, no help. Thank goodness I changed doctors, because it took me a long time to go to the doctor because we were really struggling with money. So the new doctors gave me some anti-depressants and sent me on my way.’

[On the benefits system]

‘The brown envelopes, I’m terrified of them. If one comes through the door, my body language, my heart…the children could be saying anything to me and I wouldn’t even hear it until I’ve opened it. And it’s either nothing, or it’s like, oh ‘your benefits are suspended from Christmas day’. And they always come on a Friday when you can’t do anything about it. Always. Or bank holiday weekends or something like that. I’m going to be so so happy when I never have to see another one of those ever again.’

Sally

• 18-24 age bracket.• Originally from London, moved between Hartlepool and

London before settling in Stockton. Doesn’t get on with parents.• One daughter aged 3, they do not live with her partner.• Partner worked at SSI steelworks plant in Redcar before closure.• Spends a lot of time at local Children’s Centre, taking courses

and meeting other mums.

[On dealing with ongoing pain while being lone parent]

‘I have been to the doctors before, they gave me painkillers that put me to sleep. I couldn’t take them cos I’ve got her. I did go back to them and say ‘look, I can’t take these because they put me to sleep and I can’t take them because I’m a lone parent’ and they went ‘oh, well you’re gonna have to suffer with it then…’

I struggle with a bad back as well, after having the section. So I’m contending with a bad back, a three year old and tidying up. I won’t take any medication cos I’m caring for her. I’ve had physio, I’ve had spine rehab and I do a few exercises for my back every day and I just carry on. It’s got worse in the last few years. As soon as she’s in school I’ll get it seen to.’

[On managing her partner’s expectations]

‘My partner keeps going ‘oh you’ve got to get a job soon, even if it’s just in a care home’ and I go ‘I don’t want to work in a care home. I’ll be miserable.’ I’m not going to just go out and get a job because he says I need to get a job. I’m not doing it. Plus the work wouldn’t fit around her because it can be late at night or in the middle of the day or whatever. I want a job to fit around what she’s doing and he doesn’t understand that…I’m a full time mum and he just comes and goes. He doesn’t understand how much it takes to look after her.

That’s what being a mum’s about, making sure everyone’s taken care of. I go ‘my back’s hurting’, he says ‘oh just sit down for five minutes’. But he doesn’t offer to help with anything. Just ‘sit down, you can do it in a minute’. Well if I sit down I won’t get back up. I have suffered from depression. I still have it, I think. I do still sometimes sit there and just burst out crying, for no reason. And I think…it’s from when I had her. I think it was that we don’t live together, and so all of the pressure’s on me. Everything’s on me.’

Rose

• 45-54 age bracket.• Originally from Wiltshire, from military family and

moved a lot.• Married, has two children from previous marriage.• Has an array of long-term disabilities and chronic

health issues.• Lives with her very attentive husband, daughter and

two dogs whom she adores.

[On being in crisis and seeking help]

‘We asked for help, we went to the housing for help, all these people for help, and nobody would help us. I suffer from serious depression, so my mental state was just on the floor.

I hate being like this. I hate not being mobile and not being able to work. I wasn’t bothered by the rent and that when we were both working, d’you know what I mean? We could do that. Even though we struggled.

…I feel really let down. I want some answers because I know there’s something wrong. I can understand all these x-ray machines and stuff trying to find out what’s wrong but there must be something else they can do. They cannot just like, I know it’s not in me head. I’ve been fighting for 15 year for people to admit there’s something wrong with me…It wasn’t about the money, it was never about the money. It was about somebody saying ‘yes, there’s something wrong with you’.’

[On suffering with mental and physical health issues]

‘The doctor at the hospital accepts that I am in pain, but says there’s nothing more they can do for me. Nothing shows up on the scans. Even morphine doesn’t touch me. I’m on three lots of medication for pain. When I went to see the psychologist there I said I feel like I’ve got two depressions-one is for me physical health and the other’s for the…the mental stuff. The emotional things.

I said I wanted to concentrate on the emotional things first, which I’ve been trying to do with no success. I’m still fighting the depression and all of this. I’ve come to the point where I feel like there’s nothing more I can do, everyone’s just waving me away…’

Stakeholder perspective: Tara, manager at anti-poverty charity

‘Some of the women I work with have a physical issue, but predominantly it’s an anxiety, it’s depression, it’s stress-related, and quite a lot of them have quite chaotic lifestyles as well, they could be coming from an abusive relationships, maybe they’re just young and they’ve had a child. A lot of them don’t have very good relationships with parents, siblings, so they’re not dealing with that. Some have issues with drink, alcohol. But then what’d happen is people say well if you can afford drink, you should be able to afford food. But for them the alcohol is a relief at that time.

It might not work long term but for short term it makes them feel that bit better and they’re further stigmatised for that. But mostly it’s anxiety and depression, I can’t stress enough how many people won’t come out of the house. A lot of people don’t access other services, it’s only after a few months of meeting them that you find out the true extent of their debt, their mental health problems, their other issues, cos they’re not gonna open up on day one. If you get behind the door that’s a massive step.’

Reflections• Underlying all interviews was a thread of managing (mostly, for others): the

budget, the food shop, care for ageing parents, children, benefit changes.• Of 15 women, from a wide variety of incomes, only 1, the mother with the

highest income and most secure family situation, did not mention experiencing mental health issues.

• For the women at the lower end of the income spectrum, poor physical health and poor mental health were common themes.

• Furthermore, narratives of perceived failures of medical care, of counselling services, of being offered drugs when they wanted holistic care, were common.

• All the women had wonderful experiences of their pre- and post-natal care. They spoke very highly of midwives, doctors, health visitors.

• In the wider picture of the lifecourse, a patchwork of dissatisfaction with medical care, and of multiple stressful life events emerges, often made worse by the benefit system.

• With ongoing austerity cuts and cumulative effects, we can expect the situation in low income areas to worsen.

Many thanks to all participants for sharing their stories

Thank you for listening

Email: a.a.greer-murphy@durham.ac.ukTwitter: @amygmurphy