[penagwin]

I think the real qualifier is if lack of self-care is due to personal choice then environmental resources.

You don't have clean water to regularly wash clothes/yourself? That's not a personal choice (in this instance).

If you DO have clean water and aren't taking care of your basic hygene, then there's an issue. If asked "why" and the answer is "no point" then that's a pretty clear sign of depression. "I don't know how to use my washer" would likely be an indicator of anxiety (because a "mentally fit" person should be able to figure it out, or seek help with figuring it out), etc.

[jackbravo]

But people tend to get used to the environments they grow in. So if you had low access to water, you end up learning to shower only once in a while, and you take it as something natural. Like the cliche (racist cliche?) of people in America complaining about people from Europe or Asia having a more apparent body odor. This also reminds me of the movie (or books) Dune. Where people from Arrakis are used to drinking very little water, and deem people from other planets as "fat on water" because they can even smell their "excess" off water on their bodies, and see it as a sign of wastefulness.