Unveiling America's silent struggle: Help-seeking during material hardship

Health-related social needs are increasingly recognized as significantly influencing healthcare outcomes. Material hardship, defined as the inability to meet basic needs for physiological functioning, such as food and shelter, affects many Americans. This study explores the dynamics of help-seeking behavior, focusing on the perceived effectiveness of different help-seeking channels and the primary barriers associated with each. As part of a larger research project, we interviewed 27 participants aged 18 to 70 to compare help-seekers' experiences in referral programs (n = 14) with those without such support (n = 13). Our findings indicate that people turn to formal channels for complex needs, expecting tangible solutions. They resort to informal channels for less complicated issues with lower expectations. Because expectations are lower, people often describe informal support as helpful, even when the support fails to adequately address their material hardship. In contrast, individuals find help from organizations ineffective when inadequate or too slow. Stigma significantly impedes help-seeking across both channels. Systemic barriers pose the most significant barrier within formal channels, and social isolation is the most prevalent barrier within informal channels. This research provides insights into the challenges help-seekers face by identifying and understanding the barriers associated with formal and informal help-seeking channels.