“I know growing up like that this is not discussed if someone is like depressed or if they’re experiencing anxiety. Like no one knows what that is or how to like really address it or realize like this is going to be like ongoing process and a lot of times if like someone’s depressed they’re like oh like you’ll get over it. It’s fine. Like why are you acting like that? It’s also kind of like a taboo topic like you know you’re supposed to just keep going, keep working and or like try some other sort of remedies that aren’t really going to get to like the root problems.” – Young Adult Insight

A combined 3 million Americans living in poverty are either a mother who has experienced depression or a young adult who has experienced serious psychological distress during the past year. One in four white mothers, one in three Hispanic mothers, and one in two Black mothers who have ever experienced a major depressive episode are living in poverty. These higher poverty rates are also particularly notable for young adults of color: one in four white young adults who experience psychological distress are living in poverty, compared to more than one in three Asian and Hispanic young adults and more than 40 percent of Black young adults. 

Despite the prevalence of these challenges, they are rarely discussed. CLASP’s new report, Maternal Depression and Young Adult Mental Health: Policy Agenda for Systems that Support Mental Health and Wellness, changes the conversation by opening up a policy discussion focused on these two populations. The report describes the shared structural barriers and inequities facing low-income mothers and young adults living in poverty, including disparities in the social determinants of health, disproportionate exposure to toxic stress/trauma, and disparities in access to quality mental health supports. Understanding these structural barriers and inequities can help identify needed change in systems, practice, and policies.

Even in this context, change is possible. Our report examines effective interventions, local systems-building initiatives appropriate for replication and scale, and untapped opportunities in the Affordable Care Act (ACA) and Medicaid. The report concludes with a seven-point agenda for state-level policy that turns conversation into meaningful opportunities for state action:

1. Prioritize Medicaid expansion and reject changes to Medicaid programs that create additional barriers to care.
2. Fully implement the ACA’s mental health parity and prevention provisions.
3. Build partnerships across agencies, levels of government, and types of service providers that support systemic solutions and   draw on partners’ strengths and resources.
4. Improve how care systems integrate providers at multiple levels of credentialing and with multiple backgrounds.
5. Identify effective reimbursement strategies, reduce reimbursement obstacles, and support advocates and policymakers to understand and take full advantage of existing reimbursement options.
6. Use existing Medicaid flexibility to fine-tune care and benefits.
7. Recognize that achieving equitable outcomes requires an equitable process for identifying and implementing solutions. 

CLASP plans to support this type of action through a foundation-funded, multi-year project to strengthen Medicaid, mental health, and human services policy at the federal and state levels. We will select a handful of state partners committed to meaningful policy change for low-income mothers and young adults and build learning communities focused on each population. We will then use these learning communities to generate transformative discussions and a framework that moves us toward systems that support mental health and wellness broadly. Read the report here, break the taboo, and join the discussion.