A review of the key considerations in mental health services research: A focus on low-income children and families.

Abstract

Children have been particularly vulnerable to the economic challenges of the past decade, with half (45 to 51%) of children under the age of 18 living in a low-income home and nearly 22% of those living in poverty. Low-income children are overrepresented in a range of statistics on psychosocial maladjustment issues, but their families are less likely than other socioeconomic groups to participate in mental health services and intervention research. Thus, this review asserts that substantive advances in mental health services and intervention research with low income families must move beyond a between-group, deficit-focused perspective to a more nuanced contemplation of how to: 1) Operationalize the “income” in low-income families; 2) Disentangle the interrelationship of low income, race, and ethnicity; and 3) Optimize recruitment, engagement and retention efforts via sensitivity to the culture of low-income status. Examples of mental health services and intervention research with low-income families will be discussed, and a summary, conclusions, and directions for future research are discussed in the context of these recommendations.

Optimizing Engagement in Behavioral Parent Training: Progress Toward a Technology-Enhanced Treatment Model

“…English-speaking, low-income [< 250% of Federal Poverty Guidelines (FPL)] legal guardians and their 3- to 8-year-old children with clinically significant problem behavior ( Eyberg Child Behavior Inventory Problem > 15 or Intensity > 131; Eyberg & Pincus, 1999 ) participated (see Figure 1 ). Although various measures of socioeconomic status have strengths and limitations (see Jones et al, 2016 , for a review), FPL (i.e., number of people in home or family/annual income) is generally used to determine qualification for federal, state, and local benefits, programs, and subsidies. Forty-nine states cover children with incomes up to at least 200% of the FPL (3 people in home/annual income) through Medicaid and the Children’s Health Insurance Program (CHIP) and 19 of these (including North Carolina) cover children with incomes < 300% FPL.…”

Parent–Adolescent Socialization of Social Class in Low‐Income White Families: Theory, Research, and Future Directions

“…The question that may be unique to low‐income and working‐class White families then is not necessarily the experience of a lack of access to resources, but perceived gains toward (or the promise of gains toward) and then the relinquishing of, loss, and/or never realized promise of access to those resources. To this point, the bulk of psychological research on families in general has relied on measures of socioeconomic status (i.e., combination of income, parental education, and employment/job status), federal poverty levels (e.g., for household of four adults and/or children the federal poverty limit in 2015 was $24,250), or a specific type of financial assistance (e.g., income support, subsidized housing, free school lunches) or degree of hardship (e.g., difficulty paying bills) (see Jones et al., for a review). Yet, theory suggests and research confirms that an understanding of the meaning and impact of social class and perceived inequality must move beyond such measures to capture power, or in the case of low‐income and/or working‐class individuals the powerlessness, inherent in a real and/or perceived lack of access to, as well as loss of, resources (Bullock & Limbert, ; Isenberg, ; Lott, ).…”

“…Of course, conducting such work in the context of White low‐income and working‐class families and communities, as with any other work, is not without obstacles. For example, the cultivation of isolation which we have discussed in this article make it far less likely that White low‐income and working‐class families will seek out or participate in the aforementioned prevention and intervention suggestions (see Jones et al., for a review). As such, these obstacles must be considered if substantive inroads are to be made, but we do not think progress is impossible.…”

Social Emotional Learning Program Boosts Early Social and Behavioral Skills in Low-Income Urban Children

“…Children being raised in underresourced and historically marginalizedcommunities are at a greater risk for behavioral, mental, andacademic problems, largely due to the lack of resources and high rates of exposure to adverse experiences, including chronic poverty, maltreatment, community violence, and structural racism ( Clarkson Freeman, 2014 ; Jones et al, 2016 ). Chronic and severe adversities of these sorts can exert negative impacts on the circuitry of the brain and perturb the stress response system in ways that increase children’s vulnerability to behavioral and psychological disorders ( McEwen, 2008 ; Loman and Gunnar, 2010 ; National Scientific Council on the Developing Child, 2014 ).…”