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One of the current challenges facing families today seems to be the struggles of trying to keep up financially with the cost of living and ongoing rising prices. Families without high paying jobs, pre-existing wealth, and those who have debt are more likely to experience economic hardship which creates stress when they have difficulty affording their current financial commitments (Friedline et al., 2021). The financial stress of families has created additional psychological distress for parents as they struggle to afford day-to-day expenses. There has been a sharp increase in the cost of living, drastically rising interest rates and no increase in pay. This paper examines the subtopic of access to mental health services as it relates to the main topic of socioeconomic stress on families, and the need for advocacy to improve access to affordable mental health services.
Socioeconomic status is the position on the socioeconomic scale, determined by social and economic factors such as income, education, occupation, location of residence, and ethnic or religious background (American Psychological Association, 2022). Socioeconomic status is connected to inequities in privilege, power, control, and the ability to access resources (American Psychological Association, 2022). Low socioeconomic status and financial hardship are correlated with emotional and behavioural difficulties in families (McGill et al., 2022). Emotional and behavioural challenges can lead to mental health concerns including mental illness. Mental illness includes a wide range of conditions caused by poor mental health that alter mood or thinking and are often associated with distress and impaired daily functioning (Moroz et al. 2020). Not all mental health concerns are mental illness; some are distresses, worries, anxieties, or milder symptoms that with supports and services early on can be mitigated by early intervention or mental health support.
The effect of socioeconomic strain on a family might cause parents to be more distressed, resulting in more pressure on the family. The implications are possible increases in mental health needs for families, children, and youth as they continue to struggle to meet basic day-to-day living needs. Children who grow up in low socioeconomic status tend to have poorer outcomes in health, mortality, and mental health (OACAS Library Guides, 2022). The stress of low socioeconomic status, coupled with poor or limited access to mental health care, limited or no financial resources to pay for services and medications, intensifies mental health conditions (OACAS Library Guides, 2022). Additionally, the higher levels of distress parents are in, the higher the rate of psychological distress the children are in (Low, 2022). There have been increases in reported parent-child conflict and loneliness by children and adolescents in recent years (Low, 2022). Additionally, Low (2022) suggests that the ability of children and adolescents to adjust and cope is limited when parents are distraught and unable to guide their children through distress. When there is financial hardship, families are not likely to be able to afford psychological or emotional support for their children if it is not covered by health care.
Affordable options for families
Based on what is known about the challenges that many low socioeconomic families have in managing the multiple rising expenses of day-to-day life, it is likely that they may have even more challenge accessing mental health services and resources in a timely manner. Therefore, a subtopic resulting from financial hardship that requires advocacy is access to mental health services that are free or affordable, easily accessible for families to get to, can be attained in a reasonable amount of time, and are safe. The mental health system is a large system that has the oversight of government, agencies, and policies. Policies put in place by the government are supposed to help families who are struggling financially to make ends meet. Families that need affordable and accessible mental health support for their children are not being fairly accommodated by the existing policies and procedures within the current mental health system. The national policy for child and youth mental health is a national mental health framework that was developed by the Mental Health Commission of Canada in 2010 and is primarily an online consultation service that is optional for provinces (Alimi et al., 2021). It is because of socioeconomic inequities, high costs for services, low numbers of mental health providers, and long waitlists that advocacy in justified for this topic.
Child and youth mental health policy has numerous barriers. Policy is not mandatory and it is under the supervision of the provincial governments. Funding is provided to provincial programs that have long weight list and have limited sessions available for young people and families in need. Extreme cases are overwhelming the system, and families are expected to use community services that cost money. If a family does not have private health benefits or relatively high income, they may not be able to afford community mental health providers (Malla et al., 2018). Additionally, low socioeconomic status creates family stress by contributing to parental conflict, parent-child conflict, and sibling conflict. Parents often need to work multiple low-income jobs with little or no support for parents from employers. Current literature suggests that the financial stress experienced by parents, since the Covid-19 pandemic may be impacting the well-being of children and youth because higher levels of financial stress create higher levels of psychological distress for parents. In turn, the higher levels of distress parents are in, the higher the rate of psychological distress the children are in (Low, 2022).
The Association of Counselling Therapy of Alberta (ACTA) is an organization that is advocating for the inclusion and regulation of child and youth care counsellors as mental health service providers in Alberta, Canada. ACTA is working to enhance qualified practitioners in the field of mental health by ensuring safe, ethical and skilled practice is provided to the public (Association of Counselling Therapy of Alberta, 2019). ACTA has highlighted the well-documented need for mental health services in Canada (Moroz, 2020) and demonstrate through documented practice competencies, code of ethics, and standards of practice the knowledge and skill of child and youth care counsellors (Association of Counselling Therapy of Alberta, 2019).
Child and youth care counsellors have the knowledge, training, and skills to support the mental health and well-being needs of children and youth with mild to moderate mental health concerns. As well child and youth care counsellors can work with families to support mental health care through in-home family support and in private practice, provided they keep within the scope of psychosocial and psychoeducational support. Advocacy for more qualified practitioners, such as child and youth care counsellors, to support prevention and intervention needs for mild to moderate mental health support for young people is important. ACTA continues asking the government to proclaim licensing regulations for child and youth care counsellors, allowing families to access more practitioners. ACTA is also lobbying the private benefit insurers association in Canada to include child and youth care counsellors as approved providers for families to access as well.
Conclusion
One of the issues concerning families today is the lack of financial resources to live day to day, and specifically, the lack of the resources to access quality mental health support for children. There is a lack of practitioners, wait lists, expensive services, and no support from private benefit insurance companies to access mental health support other than psychologists or clinical social workers. By lobbying for inclusion of child and youth care counsellors in licensing regulation it will allow insurance companies to include child and youth care counsellors as approved providers easily. It will also allow government sectors that are restricted to only hiring licensed practitioners under a regulatory governance body the ability to hire child and youth care counsellors in positions to provide more options for families to access mental health support. When families have more options to access mental health support (schools, hospitals, clinics, in-home support, private community practice) and can access different levels of care (psychologists, clinical social workers, counselling therapists, and child and youth care counsellors) based on their particular level of mental health support required, then the overall well-being of families and children are supported.
References
Alberta Government. (2021). Federal-provincial childcare agreement. https://www.alberta.ca/federal-provincial-child-care-agreement.aspx#:~:text=Parents%20will%20see%20reduced%20fees,they%20earn%20%24180%2C000%20and%20above
American Psychological Association. (2022). Socioeconomic status. www.apa.org/topics/socioeconomic-status
Alimi, I. O., Mathies, I., Archibald, A., Compton, C., & Keku, E. (2021). Improving child mental health policy in Canada. Cureus, 13(11): e19974. https://doi.org/10.7759/cureus.19974
Friedline, T., Chen, Z. & Morrow, S. (2021). Families’ financial stress & well-being: The importance of the economy and economic environments. Journal of Family Economic Issues, 42 (1). 34–51. https://doi.org/10.1007/s10834-020-09694-9
Low, N., & Mounts, N. S. (2022). Economic stress, parenting, and adolescents’ adjustment during the COVID-19 pandemic. Family Relations, 71(1). 90– 107. https://doi.org/10.1111/fare.12623
Malla, A., Shah, J., Iyer, S., Boksa, P., Joober, R., Andersson, N., Lal, S., & Fuhrer, R. (2018). Youth mental health should be a top priority for health care in Canada. The Canadian Journal of Psychiatry, 63(4). 216-222. https://doi.org/10.1177/0706743718758968
McGill, M., Purkey, E., Davison, C., et al. (2022). Financial stress during COVID-19: implications for parenting behaviour and child well-being. BMJ Paediatrics, 6: e001569. https://bmjpaedsopen.bmj.com/content/6/1/e001569
Moroz, N., Moroz, I., & Slovinec D’Angelo, M. (2020). Mental health services in Canada: Barriers and cost-effective solutions to increased access. Healthcare Management Forum, 33(6). 282-287. https://journals.sagepub.com/doi/10.1177/0840470420933911
OACAS Library Guides. (2022). Poverty and child welfare. Effects of poverty on families. https://oacas.libguides.com/c.php?g=702168&p=4990142
