Author: jokers tacomacc

Access to mental health treatment is essential for improving the lives of individuals and the communities they live in. The risk of suicide, substance abuse, family conflict, employment issues, and legal issues can all be lowered by improving access to this resource. Despite all of the benefits associated with mental health care, access to mental health care fails to reach the people and communities that need it most. “Poverty is a common experience for many children and families in the United States” (Hodgkinson & Lewin, 2017). “Living in a poor or low-income household has been linked to poor health and increased risk for mental health problems in both children and adults that can persist across the life span” (Hodgkinson & Lewin, 2017). In the U.S. the rate of poverty is greater than many industrialized nations (Hodgkinson & Lewin, 2017). Because of this, there is a rising demand to develop mental health care models that are tailored to the needs of those vulnerable people and communities who are disproportionately affected by poverty (Hodgkinson & Lewin, 2017).

                The lack of access to mental health treatment in the U.S. is especially marginalizing for people from low-income communities. This is partially because the majority of people from low-income communities in the U.S. who are disproportionately affected by poverty are people of color. “Although the largest number of poor and low-income children are white, minority children are disproportionately affected, particularly African American, American Indian, and Hispanic children” (Hodgkinson & Lewin, 2017). People of color living in poverty in the U.S. are the most likely people to be referred to mental health agencies for services, even though they are the least likely people to receive mental health services. “Currently, African American males lead all other race and gender groups in incarceration rates, new HIV infections, homicide deaths, poverty rates, and diagnosed learning disorders. Often the complex pathways that lead African American young men to negative outcomes include missed opportunities by both schools and community agencies to intervene with problematic behaviors at earlier ages” (Tucker & Dixon, 2009). This is often due to the fact that because many young African Americans in the inner city live below the poverty line, they are more exposed to dangerous levels of lead. Exposure to lead increases the likelihood of developing ADHD. “Boys are diagnosed with ADHD almost twice as often as girls across all races, and those who are non-white (both Hispanic and African American) are the most often diagnosed of all groups” (Tucker & Dixon, 2009). “Also, because African American youth can experience significant delays between symptom onset and initiation of services, the array of ADHD symptoms seems to be more severe than in other race and gender groups” (Tucker & Dixon, 2009).

Not only do families in rural areas have to travel long distances to access mental health services, but low-income families in general are up against many other barriers that impede their access to mental health services. “The effects of these barriers are exacerbated by the daily stressors and demands of living in poverty that can keep families from prioritizing mental health needs” (Hodgkinson & Lewin, 2017). One of the barriers to effective treatment for young African American men from low-income communities after they are enrolled in mental health services is bias in their assessment. “lack of insurance or type of ‘carve out’ and quantity of mental health services provided under managed care plans can prevent children and families from accessing needed mental health care services” (Hodgkinson & Lewin, 2017). Living in poverty, while dealing with the stigma of seeking mental health care can be enough to keep families from seeking mental health services leading to more self-doubt, blame, and self-loathing. On top of this mental health clinic hours are normally during the day which does not provide accommodation for people with low-wage shift positions.

Everybody needs access to mental health services, and there are a growing number of programs aiming to address some of the issues which effect low-income communities the most. Some of those solutions have already been implemented, and utilized successfully to address those issues effecting low-income communities. “Integrated behavioral health care within the patient-centered medical home (PCMH) is a particularly promising strategy to reduce barriers and increase access to mental health care across pediatric populations. The central characteristics of the PCMH, including a patient-centered orientation, comprehensive and coordinated team-based care, continuous access, and a system-based approach, reflect core elements that lead to improved mental health outcomes in primary care settings” (Hodgkinson & Lewin, 2017). This particular strategy can decrease the stigma associated with receiving mental health services as well as “facilitate better communication and collaboration between medical and behavioral health providers” (Hodgkinson & Lewin, 2017). Another solution to tackling the lack of access to mental health services is “Care coordination” (Hodgkinson & Lewin, 2017). “Care coordination involves the organization of patient care activities, often facilitated by information exchange between clinicians involved in a patient’s care, ensuring that services provided across settings (eg, school and primary care) are well coordinated” (Hodgkinson & Lewin, 2017).

In a personal story about a person with post-traumatic stress disorder (PTSD) and depression, some of the key difficulties facing people from low-income communities are highlighted. Trying to get help from multiple mental health facilities, this person had a hard time getting an evaluation let alone steady mental health treatment. “Not being able to hold down a job, fleeting friendships, problems with my family, not having a stable place to live, the list goes on and on. My life was slowly, but surely, falling apart right in front of my eyes. And there was nothing I could do about it but grit my teeth and try to get through it. Being poor and uninsured during most those years made it impossible for me to ever get help. And at the time, I didn’t have the resources or support system to reach out to a support group or see a low-income therapist” (NAMI). Not being able to hold down relationships and jobs are common struggles for people from low-income communities. Compounding these difficulties on top of having a mental illness can make people turn to self-medication to treat themselves. “Most days, I sat at home alone watching TV or playing video games. Other days, I sought relief from the bottle or from drugs” (NAMI). This person’s story also brings up a good point about the label associated with mental health. “Everyone around me passed it off as me being ‘crazy’ but I knew I was sick, I could feel something wrong. I knew that this was not normal. I was diagnosed with severe PTSD and bipolar disorder. I got the bipolar from one of my parents which put me in an already fragile state so the abuse I endured throughout my life made it really easy for me to develop PTSD” (NAMI). This is why early access to mental health services is so crucial for child development especially with the development of children from low-income communities.

Of the many factors that can lead to mental illness, stress is about as environmental of a cause as it gets. Stress could be a result of things like work, financial standings, and relationships. It is, however, important to understand that stress isn’t entirely negative. In the short run, stress is something that gets us moving. Stress is what motivates us to prepare for things like interviews and exams. It keeps us productive and on our toes, however, in extremes, stress can be the catalyst for mental illness. According to the National Institute of Mental Health, “With chronic stress, those same life-saving responses in your body can suppress immune, digestive, sleep, and reproductive systems, which may cause them to stop working normally”(“5 Things You Should Know About Stress”). In other words, stress can have effects that cover a broad range of health issues, including physical health. 

Although stress is often seen as a cause for mental health, it is also important to understand the effect in which mental health can have on one’s stress. The relationship between mental health and stress is actually cyclical in a way. According to the BioMed Research International, the mere stigma of mental illness can lead to worse effects of burnout(Mitake, T.). Burnout of course being a mental breakdown as a result of stress and exhaustion. Stigma, as they define it, “. . . is the misrecognition or unfounded recognition of individuals or groups with specific attributes”(Mitake, T.). In other words, stigma is when people place, often misplacing a belief that people have a mental illness. What this means is that the study is suggesting that the perception of mental illness is actually leading to burnout among groups and individuals.

So, what can be done about stress? It’s important for individuals to recognize long term stress so that people can work on dealing with it. According to the National Institute of Mental health, some of the signs that people can recognize include, “Difficulty sleeping, increased alcohol and other substance use, being easily angered, feeling depressed, and having low energy”(“5 Things You Should Know About Stress”). One of the ways in which people can deal with mental health is by getting exercise. Physical exercise can be extremely useful for dealing with stress, even if it’s in small periodic amounts. Another way in which individuals can deal with stress is by communicating with those who care about you. Being in touch with those that are comfortable with you communicating and bouncing your problems off of is a great way to better your mental health. Finally, sometimes it’s just a good idea to consult a professional. We often look at things like therapy as signs of weakness or flaw, however, if you can afford it, it’s always a great idea.

A lot of stress, as stated earlier, is going to be caused from one’s job. With this being said, good working conditions are extremely vital to reducing stress. In some cases, however, the working conditions are beyond poor quality. Arifa, a Bangladesh sweatshop worker, began working in sweatshops when she was 10 years old. During this time, she was working for about 100 taka a month. She has worked her way up to making 2200 taka a month for around 13-14 hours a day, but her wage is still extremely poor. As it’s stated, “After 20 years as a garment worker, Arifa earns more than Bangladesh’s minimum wage, but still less than a living wage”(“A Sweatshop Worker Tells Her Story”). On top of all of this, she has a family and they all live together in a poor quality slum. The work that she is doing isn’t just bad enough to have an effect on her mental health, but on her physical health as well. As it’s stated, “The work is exhausting and hard on her body, causing frequent pain, especially in the back”(“A Sweatshop Worker Tells Her Story”).