TY - JOUR
T1 - Making waves : Mental health impacts of inadequate drinking water services — From sidenote to research focus
AU - Toivettula, A.
AU - Varis, O.
AU - Vahala, R.
AU - Juvakoski, A.
N1 - Funding Information:
We thank Dr Hans-Joachim Mosler and Arto Suominen for valuable comments on the manuscript. We also thank Evgeniia Markevich, Henrik Rantanen and Dariush Salami for help in visualisation, and Roni Simola and Linnea Sirén for proofreading. The authors were funded by Aalto University and Maa- ja vesitekniikan tuki ry. (MVTT).
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/9/1
Y1 - 2023/9/1
N2 - The paramount significance of the harmful impacts of poor drinking water services on physical health have been recognized for decades. Besides, over the past twenty years, an additional body of literature on their negative mental health impacts has emerged. With this brief review, we summarise the findings of the scholarship to advance addressing overall health (physical, mental, and social) in the water sector. We furthermore review the key policy documents of this field with a focus on mental health aspects and give recommendations for practitioners and decision-makers on addressing mental health in water service delivery. We reviewed the existing published works (42) assessing psychological impacts of deficient drinking water services in low-income settings. We then identified and compared the different mechanisms causing negative mental health outcomes described in them. For these purposes, we used a water insecurity experience -model and the vulnerability-stress model of clinical psychology. Next, we probed key international and national guiding documents of the water sector to analyse how mental health issues resulting from poor services are addressed today. We found that according to the literature, poor quality and quantity of water was predictably one of the most important psychosocial stressors to users. Surprisingly, however, various kinds of water-service-related inequalities (e.g. between genders, communities or socio-economic groups) showed up as equally significant stressors. Our analysis with the vulnerability-stress model furthermore indicates that insufficient drinking water services may predispose to common mental disorders particularly through external stress. Existing field guidelines have evolved to highlight the values of non-discrimination and participation, whilst mental health aspects remain ignored. This should not be the case. Therefore, practices for addressing mental health effectively in documentation and water service development should be further researched. But already in the light of the existing literature, we urge stakeholders to focus more on the negative mental health impacts of unequal service provision for users and nearby people left without improved services.
AB - The paramount significance of the harmful impacts of poor drinking water services on physical health have been recognized for decades. Besides, over the past twenty years, an additional body of literature on their negative mental health impacts has emerged. With this brief review, we summarise the findings of the scholarship to advance addressing overall health (physical, mental, and social) in the water sector. We furthermore review the key policy documents of this field with a focus on mental health aspects and give recommendations for practitioners and decision-makers on addressing mental health in water service delivery. We reviewed the existing published works (42) assessing psychological impacts of deficient drinking water services in low-income settings. We then identified and compared the different mechanisms causing negative mental health outcomes described in them. For these purposes, we used a water insecurity experience -model and the vulnerability-stress model of clinical psychology. Next, we probed key international and national guiding documents of the water sector to analyse how mental health issues resulting from poor services are addressed today. We found that according to the literature, poor quality and quantity of water was predictably one of the most important psychosocial stressors to users. Surprisingly, however, various kinds of water-service-related inequalities (e.g. between genders, communities or socio-economic groups) showed up as equally significant stressors. Our analysis with the vulnerability-stress model furthermore indicates that insufficient drinking water services may predispose to common mental disorders particularly through external stress. Existing field guidelines have evolved to highlight the values of non-discrimination and participation, whilst mental health aspects remain ignored. This should not be the case. Therefore, practices for addressing mental health effectively in documentation and water service development should be further researched. But already in the light of the existing literature, we urge stakeholders to focus more on the negative mental health impacts of unequal service provision for users and nearby people left without improved services.
KW - Development cooperation
KW - Environmental psychology
KW - Low- and middle-income countries
KW - Review
KW - Water insecurity
KW - Water, sanitation & hygiene (wash)
UR - http://www.scopus.com/inward/record.url?scp=85165901258&partnerID=8YFLogxK
U2 - 10.1016/j.watres.2023.120335
DO - 10.1016/j.watres.2023.120335
M3 - Review Article
C2 - 37516073
AN - SCOPUS:85165901258
SN - 0043-1354
VL - 243
JO - Water Research
JF - Water Research
M1 - 120335
ER -