Chronic exposure to stress, especially in childhood, is often a predictor of later mental health outcomes. There is evidence that poorer mental health outcomes are tied to longer, or more extended, periods of stress in childhood, and it is possible that early intervention can help.
Often it can be difficult for those living in poverty to access mental health care, whether because they lack insurance coverage, their insurance does not provide adequate coverage for mental health services, or the mental health services they are able to access are not good quality.
Clinics that do offer mental health treatment often keep traditional work hours, similar to the 9-5 work schedule. These hours can be extremely limiting for individuals who have work during that time, especially those who do not have sick leave or flexible hours. Also, often appointments are scheduled at the same time regularly, which can be difficult for individuals working low-wage shift jobs with often changing schedules. For those working shift jobs, it can also be difficult to schedule appointments in advance, depending on when their schedule is made available to them.
There is another layer to perceived risk for accessing mental health care for low-income individuals. Mental healthcare has been stigmatized in the US for a long time, and some still fear having a diagnosis--or a label--and potentially being perceived as crazy or unstable. This can be a risk for parents, especially mothers, who fear their children being taken away if they are diagnosed with a mental health condition. There is also sometimes a fear of being judged by friends, family members, or their employer, which adds a complicated social layer to treatment avoidance (Hodgkinson et al, 2017).
