Barriers to Accessing Services for Mental Health, Domestic Violence, and Poverty in New York City: A Mixed-Methods Ecological Study

Across New York City, millions struggle to access support for mental health concerns, domestic violence and/or for poverty—often when they need these services the most. Yet, little research captures the voices of those most affected. This mixed-methods study, supported by local nonprofit Believe New York, sought to identify: (1) individual-level characteristics associated with barriers to help-seeking, and (2) perceived barriers at personal, interpersonal, and structural levels. A total of 736 adults with lived experience of poverty, domestic or intimate partner violence, or mental health challenges completed a survey available in commonly spoken languages in NYC (i.e., English, Mandarin, and Spanish) between November 2023 and August 2024. Participants were recruited through in-person outreach at community events and targeted online efforts. Quantitative analysis revealed that ethnic minorities, non-native English speakers, and those with financial insecurity were more likely to report difficulty accessing or trusting services. Thematic analysis of 448 open-ended responses uncovered widespread emotional, practical, interpersonal, and structural barriers. Findings underscore the urgency of developing trauma-informed, culturally responsive, and family-inclusive programs and services. Future initiatives and social service providers should incorporate public de-stigmatization campaigns, expand service availability, and actively engage marginalized communities in their unique needs and concerns.