Socio-Economic Status, Poverty, and Income Inequality as Determinants of Mental Health and Psychosocial Functioning Among Children: A Clinic-Based Cross-Sectional Study

Clin Child Psychol Psychiatry. 2025 Nov 4:13591045251391839. doi: 10.1177/13591045251391839. Online ahead of print.

Abstract

IntroductionMental health in children is significantly influenced by socio-economic status, poverty, and income inequality. However, existing child psychiatric research focuses on clinical variables and developed nations. Hence, this study explored the impact of these factors on the psychosocial functioning of children visiting a mental health clinic in India.MethodsA cross-sectional research design was employed, with data collected from children and their parents/caregivers using the Children's Global Assessment Scale (CGAS) and Indian Disability Evaluation and Assessment Scale (IDEAS). Participants included 120 children recruited from an out-patient clinic in a tertiary mental healthcare center. Non-parametric tests were employed to examine the influence of socio-economic status and poverty on functioning among the participants.ResultsOur study observed significant differences in functioning scores related to socio-economic status, monthly family income, and sources of income, with family income source significantly affecting disability scores. A significant proportion of the participants scored below the functioning benchmark and above the disability benchmark.ConclusionSocio-economic disparities and income inequality significantly influence mental health outcomes. The findings emphasize the role of social determinants of mental health and underscore the importance of integrating mental health services with socio-economic support systems.

Keywords: India; child mental health; disability; functioning; poverty; severe mental illness.

Plain language summary

Socio-economic status and poverty are not merely background factors; they are foundational determinants of mental health and psychosocial functioning among children, particularly those living with severe mental illness. In the Indian context, where sources of family income may be unstable and informal, these factors play a crucial role. While some families appear to have higher incomes from organized sectors, high financial burdens, including educational expenses, healthcare costs, household expenditures, and debts sustain chronic financial stress. This chronic economic strain undermines any surface-level financial security, leaving children highly vulnerable. This is the first study in the Indian context to examine the influence of income, socio-economic status, and poverty on psychosocial functioning and disability among children with severe mental illness. Our findings offer critical insights into the severe impact of impoverished living conditions on child development and functioning.