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Poverty transitions in severe mental illness: longitudinal analysis of social drift in China, 1994–2015

Published online by Cambridge University Press:  23 February 2021

Yue-Hui Yu
School of Public Administration and Policy, Renmin University of China, Beijing 100872, China
Wei Luo
Chengdu Xinjin Second People's Hospital, Xinjin, Chengdu 611432, China
Bo Liu
Jingzhou Mental Health Center, Jingzhou, Hubei 434000, China
Wei-Hong Kuang
Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China
Larry Davidson
Yale University, School, New Haven, CT, USA
Cecilia Lai Wan Chan
Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
Lin Lu
Peking University Sixth Hospital, Institute of Mental Health, Peking University, Beijing 100191, China
Meng-Ze Xiang
Department of Psychiatry, West China Hospital, Sichuan University, Chengdu 610041, China
Mao-Sheng Ran*
Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
Author for correspondence: Mao-Sheng Ran, E-mail:



Although poverty associated with severe mental illness (SMI) has been documented in many studies, little long-term evidence of social drift exists. This study aimed to unravel the poverty transitions among persons with SMI in a fast change community in China.


Two mental health surveys, using the International Classification of Disease (ICD-10), were conducted in the same six townships of Xinjin county, Chengdu, China in 1994 and 2015. A total of 308 persons with SMI identified in 1994 were followed up in 2015. The profiles of poverty transitions were identified and regression modelling methods were applied to determine the predictive factors of poverty transitions.


The poverty rate of persons with SMI increased from 39.9% to 49.4% in 1994 and 2015. A larger proportion of them had fallen into poverty (27.3%) rather than moved out of it (17.8%). Those persons with SMI who had lost work ability, had physical illness and more severe mental disabilities in 1994, as well as those who had experienced negative changes on these factors were more likely to live in persistent poverty or fall into poverty. Higher education level and medical treatment were major protective factors of falling into poverty.


This study shows long-term evidence on the social drift of persons with SMI during the period of rapid social development in China. Further targeted poverty alleviation interventions should be crucial for improving treatment and mental recovery and alleviating poverty related to SMI.

Original Article
Copyright © The Author(s), 2021. Published by Cambridge University Press

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