By Sophia Capolupo
Extensive research shows that economic hardship is closely linked to worsened mental health and long-term health outcomes. A 2022 study published in the Journal of Youth and Adolescence found that lower family economic status increases youth exposure to physical and social environmental risks, as well as higher rates of adverse childhood experiences, which are associated with anxiety, depression, and behavioral challenges.
Felica Turner, a mother of six and a certified peer and grief specialist at Behavioral Resource Center of Dane County, sees these systemic barriers firsthand.
With nearly a decade of experience, Turner has found that low-income youth today are in a state of constant “survival mode.”
“When youth experience unstable housing and financial instability, it is the nature of the beast,” Turner said. “Instead of focusing on learning, relationships, and personal growth, your mind is wondering where you will sleep, which hotel you will go to, if the lights will be shut off or if you will have food tomorrow.” That type of stress, she added, triggers “the fight, flight or freeze response early in life and for longer periods.”
The scope of the crisis
Youth experience heightened vulnerability to psychological distress throughout early adolescence and into their early twenties. This critical developmental period coincides with persistent health and socioeconomic disparities across the U.S.
A national study conducted in 2021 found that approximately 82% of U.S. youth with anxiety do not receive adequate mental health care. Youth facing systemic barriers include those in lower socioeconomic groups, those with adverse childhood experiences, or those experiencing racial marginalization. Collectively, youth facing systemic barriers represent the highest-risk group for poor health outcomes, yet have the least access to services.
Data from the U.S. Department of Commerce in the 2020 income and poverty report showed that nearly 36% of American children lived in or near poverty in 2020, and even families above the federal poverty line reported significant stress‑related hardships. According to a 2022 public health report by former U.S. Surgeon General Dr. Vivek Murthy, the COVID‑19 pandemic further exacerbated these disparities by intensifying economic instability and mental health strain.
Students in Dane County “living in poverty are twice as likely to experience mental health concerns, yet only about 20% of low-income individuals receive services,” compared to 50% of their higher-income peers, Turner said in an interview.
Persistent hardship fuels a feedback loop for both children and parents. Parents working to improve their financial or housing stability often experience chronic stress, which can limit their emotional availability and capacity to respond to their children’s mental health needs. This stress frequently appears as reduced patience, emotional withdrawal or physical and mental exhaustion.
A parent overwhelmed by rent, job insecurity, debt or food insecurity is more likely to react “quickly rather than respond thoughtfully,” Turner said.
In some instances, she added, family stress leads to role reversal and “parentified” children—youth who care for siblings or attempt to provide emotional or financial support to the adults in their lives. These children often suppress their own needs out of concern for their families, she said.
“When children grow up in persistent hardship, they may believe stability is impossible or that certain opportunities aren’t meant for them,” Turner said. “That hopelessness makes planning for the future feel pointless. It creates a risk of risky behaviors, disengagement from school and suicidal ideation.”
Turner explained that prolonged hardship can significantly affect a child’s outlook on the future and diminish their capacity for hope. Further, kids have less time and emotional availability to focus on academics or social relationships.
Researchers in a 2020 Science study found that long‑term exposure to poverty in childhood is linked to increased rates of depression and anxiety, as well as lasting physical health effects.
A potential solution: single-session interventions
To address health inequities, researchers have emphasized the value of cost‑effective, time‑efficient strategies. A promising approach is to offer single‑session interventions, or ‘SSIs’: one‑time therapeutic encounters designed to provide immediate support and practical coping tools. These sessions can be time-efficient and cost-effective compared to traditional therapy models.
Studies suggest that culturally responsive SSIs can be particularly beneficial for low‑income families because they require minimal time, transportation, and financial resources. A 2021 randomized controlled trial published in JMIR Mental Health found that a single‑session intervention helped parents reduce accommodation behaviors associated with child anxiety.
Project EMPOWER, a web‑based, self‑guided SSI for parents, offers a key example of how interventions can be made more accessible. In a 2020 experimental trial, parents who completed the program reported improvements in distress tolerance and their responses to child anxiety.
Despite promising findings, the Project EMPOWER trial had notable demographic limitations. Participants were overwhelmingly female, predominantly white and highly educated — demographics that do not reflect the marginalized communities most affected by mental health inequities.
“These one‑time sessions are helpful because they’re designed to provide immediate tools and relief,” Turner said. “They’re also more accessible than many traditional models in terms of cost and transportation.”
Turner emphasized that without cultural context and lived experience, even evidence‑based interventions may fall short. She described prominent barriers to care, including cultural mismatch, complex referral systems, eligibility criteria and complicated intake processes.
“As a Black woman, I know that cultural context shapes how people understand mental health,” she said. “We need providers who understand the lived reality, values and language of the people they work with.”
Community-level approaches & the youth perspective
Research indicates that moving away from traditional clinical environments is essential to improving youth engagement. A 2016 study examining youth perspectives on mental health treatment found that young people value authentic connection and autonomy, while clinical settings and logistical burdens act as significant deterrents.
This insight has driven interest in person‑centered approaches that prioritize understanding how families perceive their struggles rather than focusing solely on diagnoses. A 2021 study published in the Journal of Clinical Child & Adolescent Psychology found that culturally informed, person‑centered assessments improved both service engagement and outcomes.
Community‑driven models that center youth perspectives have been identified as critical tools for addressing health disparities. Public health research published in 2025 highlighted the importance of patient-centered approaches in strengthening resilience in underserved communities.
In a 2022 publication, former U.S. Surgeon General Dr. Vivek Murthy outlined three strategies to improve access to youth mental health support: Creating safe, trauma‑informed and culturally responsive environments; systematically screening children for mental health risks, such as adverse childhood experiences; and expanding support for families facing food or financial insecurity.
Turner said that in Dane County, these strategies could include trauma‑informed teacher training, expanded school‑based services and housing stability programs paired with financial literacy education. Action must take place within families and broader communities alike. Through culturally informed, low‑barrier interventions, communities can move toward greater equity and a healthier future for all youth.
