Structural Violence and the Social Determinants of Mental Health: Exploring the Experiences of Participants on the Ontario Basic Income Pilot in Ontario, Canada

Abstract

Introduction: In 2017, a provincial Liberal government launched the Ontario Basic Income Pilot (OBIP) to assess a promising approach to poverty reduction in Ontario, Canada. It was prematurely canceled by a subsequent Conservative government, despite election promises assuring that it would continue. The cancelation affected 4000 OBIP recipients.

Objective: This study explored how participants’ lives were on the OBIP compared to their lives before and after the pilot project using the social determinants of mental health (SDoMH) as a key lens.

Study Design and Data Collection: Semistructured interview data, gathered in 2019, were collected from a sample of 46 OBIP participants from three study sites, viewed through the lenses of structural violence and the SDoMH, and analyzed using reflexive thematic analysis.

Findings: We identified eight themes from the data, all of which pointed to the positive impacts of the OBIP on the SDoMH of participants. These included expanded opportunities for education and employment, improved housing stability, enhanced social inclusion (including an escape from the denigrations of receiving charity), improved sense of security and mental health, the wherewithal to eschew “crappy foods” in favor of healthier options, and the freedom to live one’s life as one chooses. All these positive impacts were threatened or reversed by the Pilot’s cancelation.

Conclusions and Implications: The discontinuation of the OBIP, a benefit that appeared to be improving the mental health and well-being of OBIP participants, can be viewed as an act of structural violence by government leaders. This study contributes to the growing evidence showing that cash transfer programs, such as a basic income, can alleviate psychological distress and improve mental well-being for people living in poverty. A groundswell of mobilized citizens, and public health and mental health practitioners specifically, must hold governments accountable for acts of structural violence that can readily be addressed through policies that eradicate poverty.