Can you really die of shame? Can stigma be lethal? It is easy to think about poverty purely in relation to how much money people have and their material standard of living. But emotional suffering and shame are central to the experience of poverty. Even in the eighteenth century, Adam Smith commented that a linen shirt and leather shoes had been “rendered … necessary” by “custom”; “the want of which would be supposed to denote [a] disgraceful degree of poverty” (Smith 1776). A 2012 study published by the charity Turn2Us divided the shame and stigma experienced by people in relation to benefits into three categories (Baumberg et al. 2012):

• 1. Personal stigma – the feeling of shame at having “failed”, not being able to have and do the things that others can, being reliant on benefits or charity.

• 2. Social stigma – being judged by others as a failure, morally suspect, being to blame for your situation and wrongly claiming benefits or taking charity.

• 3. Institutional stigma – being treated badly by service providers, feeling humiliated by the process of claiming benefits or accessing other services.

All of these come up again and again among people in poverty, especially those with experience of the social security system and people using food banks. The 2012 study found that around three in ten of those with experience of claiming benefits had experienced moderate or high personal stigma, nearly half reported feeling social stigma and a whopping 85 per cent experienced institutional stigma.

Health studies have linked these feelings of shame and stigma to increased mental and physical health problems. A review (Elliott 2016) of the links between mental health and poverty highlighted the impact on young people's mental health. It found that “chronic exposure to poverty increases adolescents’ risks for developing conditions such as depression, and behavioural risks such as substance use, early sexual behaviour and criminal activity”. Girls were more likely to become depressed and boys to drink too much. Tellingly, it cited the impact of “a sense of helplessness and feelings of shame and inferiority”.

Many studies have documented the feelings of humiliation and distress felt by some benefit claimants, both because of media portrayals of them (social stigma) and the way they have been treated when claiming social security (institutional stigma):

Q: How are benefits claimants seen?

Alan: OK, ermm, parasites, skivers, work-shy, lazy, stupid, Feckless.