Access to mental health care for poorer children in wealthier communities

The relationship between income and the risk of mental illness has been extensively studied in the US.  Generally speaking, the higher one’s income is the lower the risk for mental illness.  This also holds true for the income of the community as well.  But, that doesn’t mean that the higher income communities in the state are without residents who, unfortunately, struggle with mental health needs.  This is especially true in communities with greater income inequality. 

Schools can play an important role for a child of lower income families with mental health needs, according to a Center report on accessing mental health services in schools.  This survey revealed one very surprising result – schools with students of economic means find it more difficult to provide services for students who have a mental illness.  The graph below shows the percent of schools reporting difficulty in providing specific mental health services to students (using the school’s enrollment for Free and Reduced Price Lunch as a proxy for the average wealth of the community).  In all but one category, schools with below average enrollment in Free and Reduced Price Lunch reported more difficulty in providing services for their students than school with a higher concentration of lower income children.

 

Presumably, children living in higher income communities are more likely to have healthcare coverage. And, it is possible that children with sufficient health care coverage may seek treatment in a private setting over services that a school may provide, creating a disincentive for schools to provide a pathway for services.  Other reasons why schools in higher income communities struggle certainly exist, such as the stigma of mental illness.  But, the true answer remains unclear.

However, one question raised by these data is of particular importance to lower income children living in a generally higher income community.  Do children of lower income families, without sufficient healthcare coverage, and with mental health needs attending these schools will find it more difficult to access the services in their communities?

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