Who fairs better and why: mental health, money, and resiliency

By Robin Sax

Poverty, race, and class are considered significant determinants of mental health outcomes.  Most research cites a higher prevalence of disease, greater risk for physical, mental, and emotional health issues among poor people and people of color (Bradley & Corwyn, 2002).  The converse assumption is that wealthy, white, and privileged are likely to fair better. The hypothesis of wealth being a protective factor has been the subject of research and curiosity to scientists and the public alike.  The data has shown that there be something to the concept of “affluenza” and rich kids could be at higher risk for mental health issues, substance abuse, and may be less resilient than their poor counterparts (Masten, Powell, & Luthar, 2003).  I work in a community mental health agency where my clients are poor and are mostly people of color. At the same time, I have a private legal practice in the Westside of Los Angeles where my clients have criminal and family law issues where underlying mental health components are at the root of the case.  Substance abuse, trauma, abuse, are some of the more prevalent issues behind crimes, custody, and other legal issues. My private practice clients tend to be white and of much higher socio-economic means than my community agency counterparts. (It should be noted that much of the “affluence” of my younger clientele is not their direct resources but rather their access to money vis a vis their parents).  In both groups, my clients have both mental health issues that may or may not have spurred a legal issue as well. And if there isn’t a legal issue yet, there is always the worry that an arrest, an eviction, a restraining order or a 5150 hold is on the way. As I tread both worlds, people often ask which group of clients are better off? Who fairs better –the community agency clients or the private clients?  And,why?

I work with people of all ages but in both my practices a great deal of my clients are adolescents, transitional age adults, young adults, and emerging adults and/or their parents. I mention all of these different developmental terms as it is critical to the understanding of the issues that young people and their parents face regardless of wealth, class, or race. The notion that adulthood is broken into various phases is just one of  the characteristics of modern society that in and of itself may provide context to the prevalence of mental health issues facing young people and their parents today. According to psychologist Jeffrey Arnet (2014), the term emerging adulthood lies between adolescence and young adulthood. Current thinking classifies adolescence from ages 12-18, some recognize transitional age youth as spanning ages 16-24 and is widely used in the foster care system, emerging adults are between ages 18-25, and young adulthood begins in the mid-twenties and can last into the early thirties. Jeffrey Arnett coined the term “emerging adult” in order to capture the reality that in today’s young people who otherwise would be considered an “adult” by virtue of the law do not have the qualities normally associated with being an adult i.e being out of school, living on their own, being financially independent, being married, etc.  The notion that young adults are not independent and still living with and/or are dependent on their parents for more than just emotional support is what creates the greatest discrepancy in the mental health outcomes in my different practices. 

In my two practices, the single greatest determinant of one’s ability to navigate life, recover from setbacks, ability to cope, etc. boils down to one factor- resiliency.    Resilience refers to an individual’s ability to positively adapt to various situations while experiencing adversity (Farber & Rosendahl, 2018).  Resilience comes from having honed life skills while also having an internal sense of comfort in one’s ability (to make good choices, to succeed and to be independent).  The mastery of skills related to independence, resourcefulness, scrappiness, and motivation is the foundation for a resilient person. My clients who are forced to take care of themselves, have to go to school and/or have to work to survive, are the ones that do the best.  Their competence in handling their life and “adulting” brings about more confidence, more routes for (positive) social engagement, and less time to tune out by using substances, surfing the web, scrolling social media, playing videogames, or doing nothing.  

Clients in both worlds have faced trauma, loss, grief, divorce, abuse.  Some have been victims of protracted long and horrible abuse. Some of which has been abuse by family members.  Some have had therapy but many of them come from families who shun intervention and look at therapy as a weakness.  In my agency life, many of my clients have been in foster care, group homes, and may not even know their parents.   In my private practice, I see more and more young adults between 20-30 years old who come from wealth, have had every advantage offered to them, attended the best schools, had access to therapy, live in homes in the safest of neighborhoods, drive fancy cars, and have every designer handbag you could think.  And, yet they suffer the same (and sometimes more) than their less privileged counterparts. These kids are miserable, depressed, anxious, eating disordered, abused and soothe themselves by abusing opioids, alcohol, and a litany of other substances, engage in risky behavior and often come to me when they are facing forced hospitalization and/or incarceration.  They are being arrested for crimes and being held on psychiatric holds against their will.  And, what do their parents say?  “How can we save them?” “How can we get them off?” “How can we help them avoid suffering?”  Parents call desperate, scared, and in search of a quick fix. And, therein lies the problem.   My wealthy kids’ parents are stunting their children’s ability to be scrappy, to face adversity, to figure things out as they cannot bear the idea of letting them suffer, cutting them off financially, or letting them hit rock bottom.  

My practice is filled with wealthy parents who ensure that their children have every possible opportunity and are accustomed to bringing in teams of people, experts, consultants and whomever might be necessary in order to “get the job done.”  (Read: Get them off, not suffer, not cause lasting consequences.) Take the College Blues Scandal, for example, a parent who desperately doesn’t want their kid to suffer sends their kid to the best private school, hires the best tutors, makes sure they are on the most prestigious dance or sports team, sends them on summer “service” trips in Thailand and Bali, insures they apply to the “best” non-profits to “volunteer” hires them a college counselors who may or may not be doing more than reviewing essays and finding a good fit, delivers them to college only to decorate their rooms like a second home in The Hampton and then somehow thinks that they are prepared to function like adults, knows how to make good decisions, and are ready to be launched.  Sounds like it should all be good, no? Not quite.  

While my community agency clients may face the same rates of anxiety and depression and may have endured “more trauma” by way of both living in abusive situations and witnessing abuse, these clients also tend to be more resilient.  They respond to therapy quicker and are more open to change. Why? In my view it’s because they are more resilient, and they are more resilient because they have had to be more resilient. Their parents may have wanted to fix everything and afford their kids every possibility but simply couldn’t because they could not afford to, working multiple jobs, and did not have the access to resources that the wealthy have. They were forced to let their kids find the answers to questions from others, let them hit fail or even hit bottom, they have even kicked their kids out of the house if they were not doing their part, they didn’t create an expectation that they were going to be taken care of forever, and most importantly they let their kids learn from their mistakes out of necessity.  Making it through these adversities have taught these young kids that they can succeed thus providing them a sense of confidence stemming from competence that they found when they have figured things out on their own.

Whether rich, poor, or somewhere in between life is full of ups and downs. The greatest single gift a parent can give their child is to provide a sense of reality and model resiliency. Life does not look like what people’s peers post on Instagram, Snapchat or Facebook. Adversity and difficulty are realities of life.  The biggest gift parents can give their children is to arm them with the tools to become resilient and that means not bailing them out when they fall, not be co-conspirators in their desire to avoid pain, and to teach them that they can and will make it through even the most difficult and dark times of growing up. Children learn from what they see their parents do.   When children see their parents hire experts, fix things before a child can, catch balls before they fall, they are being told through silent messages, “I doubt you.” Though parents may feel like they don’t want their kids to feel pain, the need to teach kids that they can feel pain and overcome as that is the only way to build the resiliency muscle.


Arnett, Jeffrey Jensen. Adolescence and emerging adulthood. Boston, MA: Pearson, 2014.

Bradley, R. H., & Corwyn, R. F. (2002). Socioeconomic status and child development. Annual review of psychology53(1), 371-399.

Färber, F., & Rosendahl, J. (2018). The Association Between Resilience and Mental Health in the Somatically Ill. Deutsches Arzteblatt international115(38), 621–627. doi:10.3238/arztebl.2018.0621

Masten, A. S., Powell, J. L., & Luthar, S. S. (2003). A resilience framework for research, policy, and practice. Resilience and vulnerability: Adaptation in the context of childhood adversities1(25), 153

Copyright 2019 by Robin Sax. All Rights Reserved.

Robin Sax is a former Los Angeles County Deputy District Attorney who focused on prosecuting sex crimes against children. She is an experienced litigator with an emphasis on criminal and family law. Robin has represented victims of crime as well as the people who have been falsely accused of crimes in order to gain advantage in a family law case. Sax is a nationally recognized expert in child sexual assault, domestic violence, and child abuse.

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