Mental Health and Life Choices
This week I did some interviews for my research on geographic, socioeconomic and racial disparities in the mental healthcare system. From reviewing previous literature on the topic, I realized that many researchers had approached this issue by analyzing nationally representative data. You would imagine — the results deal with the whole nation and are very macroscopic. So I thought that, with some in-depth qualitative interviews, I could get better understanding of the issue from a more microscopic perspective, and perhaps, discover something new. Guess what? I was right. Even though the sample size was very small, the responses still surprised me quite a bit.
Socioeconomic disparities in the healthcare system has been well documented in the past. For instance, researchers at the University of California, San Francisco and Harvard University discovered that, individuals with low income are consistently less healthy than their wealthier counterpart. Even within the small boundary of Los Angeles County, residents in the “wealthier” part of the town could have a life expectancy 12 years longer than those in the less affluent part (as I mentioned in one of my blog posts!). Knowing the numbers, and of course being a not-so-sophisticated researcher, I thought I would get drastically different responses like, “Oh, I’ve got a hundred therapists living in my mansion.” and “What is that again? Do you mean a counselor?” As I said earlier, the actual responses were quite surprising.
So, what did the participants say? Well, I could tell you upfront — neither the high income individual, nor the low income one is actively using mental healthcare resources. When I asked about what they did to cope with psychological difficulties, and whether they had visited any mental healthcare professional to address their issue, the participant from a low income household said,
“My kid is seeing a counselor and he’s been making progress. I would like to try it myself some day, but I’m afraid it might mess with my work schedule, and I’m not sure if my insurance plan covers it.”
Okay, so the socioeconomically disadvantaged individual doesn’t use the services as much. I went on and interviewed someone from a high income household, and he said,
“Actually, no. Talking to someone doesn’t solve the problem, but if I work on the problem itself, things get better eventually. I’d rather focus on my life goals than my emotional disturbances.”
To my surprise, the rich doesn’t really use mental healthcare services, either!
Ostensibly, individuals from neither high nor low income households are actively using mental healthcare resources. Nevertheless, with further inspection, the underlying reasons could be more than the different socioeconomic status. The individual from low income household expressed concerns that attending counseling sessions might affect her work schedule, whereas the one from relatively high income household valued his life goals more than emotional disturbances. To me, this sounds more like an issue of life priorities and personal choice. Now that policymakers and healthcare organizations are trying hard to expand resources in the underserved communities. Perhaps, it’s also crucial to take some other factors into account. To some of us, we really need that extra shift to be able to put food on the table. Even with the expansion of available resources, it’s still a battle to find the harmonic balance between financial situation and mental health.
