Behavioral Health
Article

Residents with low income aren’t getting the mental health care they need

Alex Dorman
Research Fellow
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March 11, 2024
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A 2023 Center for Community Solutions survey invited residents in Cuyahoga County with household incomes below $35,000—just below the Federal Poverty Level for a family of five—to share their experiences. Each participant was asked if they had needed mental health services or counseling since 2020, and as a follow-up, if they had successfully gotten the help they needed. It is well documented that the reported need for mental health services and counseling has been rapidly growing.  

The most prevalent barriers to healthcare access link to issues with affordability.

Barriers to accessing mental health care

Americans are spending more on their mental health than ever before, and resources are being pushed to the limits. But access to necessary mental health care needs is not equitable. To explore barriers to accessing mental health care, a 2021 study of over 50,000 adults in the United States concluded, “The most prevalent barriers to healthcare access link to issues with affordability.” Community Solutions has explored barriers to accessing mental health care before, most recently in a community survey sample from Ashtabula County.  A striking finding from that survey was that less than 30 percent of respondents with private insurance showed that they would be able to find a behavioral health provider when they needed one. So, what of our neighbors with lower incomes in Cuyahoga County? What has been their experience in needing mental health care in the last few years, and have they gotten the services they needed? The visualizations may offer some insight into these questions.  

Who reported needing help?

Who got help?

Key takeaways

  • In a sample of 410 Cuyahoga County residents from households earning less than $35,000 annually, 42 percent of respondents reported needing assistance with their mental health in the last few years.  
  • Nearly one in five respondents (18 percent) reported needing help but not getting it.  
  • Black and white residents reported similar levels of need, but white residents (66 percent) were more likely to have received help than Black residents (47 percent).  
  • A smaller proportion of males (36 percent) reported needing help than females (47 percent).
  • A greater proportion of males who needed help reported receiving help than females
    • Of men who reported needing help; 64 percent got it vs 54 percent of women who reported needing help.
  • When it came to getting help, being in a relationship or being single marked a large difference for men.
    • Partnered men reported getting help more often (79 percent), compared to single men (58 percent)

Concluding thoughts

This data provides insight into the experiences of residents with lower income in Cuyahoga County and their potential mental health needs. It is certainly not exhaustive, nor is it causal. We did not have enough data to explore the needs of individuals who did not identify as male or female, or who were not Black, white, or Hispanic, so in these ways the information is incomplete. It can still, however, call attention to the very real and present mental health needs of lower-income households in Cuyahoga County, with an acknowledgment that the cost of services is a barrier to getting those needs met. My colleague, Policy Associate Kyle Thompson, has analyzed the funds allocated to mental health and addiction services from the new state budget, identifying a $313 million dollar budget increase from fiscal year 2023, totaling 1.2 billion dollars in funds for the Department of Mental Health and Addiction Services.  An increase in funds for continuum of care services could be used to provide more mental health help to vulnerable populations like these lower-income households in Cuyahoga County. It is also important to vote to maintain the health and human services levee (Issue 26) in Cuyahoga County, so that funds designated to address behavioral health services in the county are not lost. You can also read about other important health and human service levies up for vote this March throughout the state here.

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