Poverty and Mental Health: How Counselors Can Help

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Whether dealing with substandard housing, navigating neighborhoods with high crime rates or struggling to access adequate health care, people living in poverty often confront realities that take a heavy toll on their mental health. Research in Science reports that in recent years numerous studies have found a causal link between poverty and poor mental health. The data reveals that people living in poverty are at a higher risk for mental illness and also report lower levels of happiness.

A parent sits on a cot with their arm wrapped around their child in a shelter.

Aspiring counselors who want to provide mental health services to this vulnerable population can benefit from gaining a clear understanding of the link between poverty and mental health. Earning an advanced degree, such as a  , can equip individuals with the skills necessary to provide mental health services to these communities in need.

The Link Between Poverty and Mental Health

Poverty can touch just about every aspect of a person’s life. It often affects people’s ability to access a quality education and properly manage their physical and mental health. This creates ongoing and intense stress, a serious risk factor for poor mental health.

Additionally, the economic stresses, barriers to healthy lifestyles and history of trauma common among those living in poverty can harm both physical and mental well-being. People living in poverty regularly worry about having enough money to pay their rent, go to the doctor or feed themselves. They tend to eat more processed foods because they can’t afford nutritious fresh foods. If they have housing, they often live in areas prone to violence. This exposes them to trauma and can keep them from going outside to get needed exercise.

It’s important to note that the relationship between poverty and mental health flows both ways. While poverty can contribute to mental health problems, mental health problems can also exacerbate poverty. For example, individuals living with an untreated mental illness, such as bipolar disorder, often find that their conditions make it harder to escape economic difficulties if social withdrawal, confused thinking or extreme mood swings get in the way of keeping a job. This employment instability can keep them in a perpetual struggle to make ends meet.

That stressful state can overwhelm them and further trigger the symptoms of their mental health condition, making it even more challenging for them to secure and maintain employment. In this way, mental health problems can entrap people in a cycle of poverty.

 Poverty and Depression

Data from the Centers for Disease Control and Prevention (CDC) shows that, compared to adults in higher-income households, those living below the federal poverty level experience mental distress 70% more often. The social stigma of poverty, combined with frequently dashed hopes of buying a home or attending college due to poverty, frequently lead to distress that can manifest as depression.

Conversely, depression can negatively influence people’s thinking and perceptions. This can then distort the choices they make regarding how much they work and where they spend their money. Depression can also hamper productivity levels. Together, these effects can have unfortunate economic consequences.

Poverty and Anxiety

The challenges of living in poverty frequently create and aggravate anxiety. Living in low-income neighborhoods often exposes residents to stressors such as pollution and poor sleep environments. Additionally, unstable income, safety concerns and unmet health care needs — all experiences associated with poverty — often lead to high levels of anxiety.

On the other hand, studies have found that services and programs that help alleviate these types of stressors, such as cash transfers or improved health care access for individuals living in poverty, can reduce anxiety in meaningful ways.

For example, a Quarterly Journal of Economics study found that low-income families given cash grants that doubled their yearly income reported higher levels of life satisfaction and lower levels of anxiety than they did before receiving the money.

Poverty and Substance Misuse

Although researchers haven’t yet clearly established a relationship between poverty and substance misuse, a good deal of evidence suggests a link exists.

According to the United Nations, unemployment triggers poverty. A recent study published in BMC Psychiatry found that substance misuse increased among the unemployed and concluded that economic difficulties can provoke substance misuse.

Research also suggests a possible connection between childhood poverty and substance misuse. A strong relationship exists between adverse childhood experiences, or traumas experienced during childhood, and mental health in adulthood.

Multiple childhood traumas put people at an even greater risk for substance misuse. According to a BJPsych Bulletin study, children in low-income households experience multiple childhood traumas at considerably higher rates than other children. Given this finding and the link between multiple childhood traumas and a propensity toward substance misuse, it’s likely that poverty plays a role in substance misuse.

How Counselors Can Help With Poverty and Mental Health

Despite the prevalence of depression, anxiety and other mental health issues, those living in poverty often don’t receive the treatment they need. However, by applying intervention programs designed to address the needs of people living in poverty, counselors can help bring about change.

In addition to socioeconomic considerations, mental health intervention programs should also keep in mind the needs of diverse communities. For example, because both poverty and race strongly correlate with disparities in mental health care, it’s critical counselors cultivate an understanding of Black mental health issues, along with knowledge about the unique mental health issues of other communities of color. This can help remove persistent barriers to mental health care faced by underserved and low-income individuals of all backgrounds.

Bringing mental health care to low-income communities yields many benefits. In addition to increasing peace of mind and life satisfaction, mental health care can have positive effects on people’s rate and length of employment, as well as on their finances. As people’s mental health improves, so do their financial situations.

Counselors and other mental health professionals step up in a number of ways to combat poverty while also improving the mental health of their clients.

Help Create Mental Health Education Programs

Providing information about the relationship between poverty and mental health to service providers, charitable groups, community volunteers and the public can support efforts to help low-income communities get the assistance they need. Mental health education programs can teach people about mental health conditions, symptoms and forms of treatment. They can also help to dispel the stigma attached to mental illness and poverty and better help marginalized populations.

Help Provide Access to Affordable Mental Health Care

Counselors can also opt to work for programs that offer mental health services to low-income populations. These can include public assistance programs, government work and nonprofits. Counselors may also choose to offer flexible payment options or sliding-scale rates for clients who may not have the means to afford typical counseling rates.

Help Fight Poverty and Mental Illness with a Master’s in Counseling

Individuals inspired to help alleviate the stresses of poverty while also helping clients overcome mental health disorders can make a difference as a counselor. Explore how Wake Forest University’s online Master of Arts in Counseling program can help you cultivate the skills necessary to navigate poverty and mental health and build a meaningful counseling career.

Recommended Readings

How Crisis Counselors Can Help a Community Heal After Tragedy

The Rise of the Non-Profit: How Counselors Can Help Solve Problems in Their Communities

The Role of the Substance Abuse Counselor in Addiction Recovery


Addiction, “Association Between Poverty Exposure During Childhood and Adolescence, and Drug Use Disorders and Drug‐Related Crimes Later in Life

American Association for the Advancement of Science, “Exploring the Connection Between Poverty and Mental Illness”

BJPsych Bulletin, “Poverty and Mental Health: Policy, Practice and Research Implications”

BMC Psychiatry, “Unemployment Rate, Opioids Misuse and Other Substance Abuse: Quasi-Experimental Evidence From Treatment Admissions Data”

Centers for Disease Control and Prevention, “Frequent Mental Distress Among Adults, by Disability Status, Disability Type, and Selected Characteristics — United States, 2018”

Psychiatric Services, “U.S. Health Care Reform and Enduring Barriers to Mental Health Care Among Low-Income Adults With Psychological Distress”

The Quarterly Journal of Economics, “The Short-Term Impact of Unconditional Cash Transfers to the Poor: Experimental Evidence From Kenya”

Science, “Poverty, Depression, and Anxiety: Causal Evidence and Mechanisms”

United Nations, Employment and Decent Work