Well-Being Mental Health

Food programs with work requirements led more people to need mental health care

“We found that women were impacted much earlier by work requirements compared to men, in line with a host of studies that have documented an association between food insecurity and poorer mental health outcomes among women.”
Sign for Food Stamps.
The Associated Press/Seth Wenig

Story at a glance


  • The Supplemental Nutrition Assistance Program (SNAP) is designed to help low-income families struggling with food insecurity.

  • However, some states have tacked on work requirements to SNAP benefits, adding an additional hurdle to these populations struggling for food.

  • For the first time, new research shows these work requirements are linked with more visits to mental health providers among SNAP recipients.

Individuals who receive Supplemental Nutrition Assistance Program (SNAP) support with the caveat of work requirements were more likely to need mental health care for anxiety and mood disorders, according to data collected from West Virginia. 

Food insecurity is already associated with poor mental health outcomes, as is job insecurity, while the nation is currently struggling with a mental health care provider shortage

SNAP provides eligible low-income families with federal nutrition assistance, and in 2015, more than 20 million families participated in the program, researchers said. However, some recent work requirement policies have been implemented in several states, which could pose barriers to those who most need the services. 

To better understand what effect these requirements have on enrollees’ mental health, researchers assessed data from West Virginia, which rolled back work requirement exemptions in some of the state’s counties.  


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A total of 65,157 Medicaid enrollees across nine counties were included in the study. 

Using Medicaid claims data collected between 2015 and 2018, analyses showed work requirements were associated with a 0.9 percentage point increased risk of having a mood disorder visit among women. Similarly, a 0.7 percentage point increase was seen among men.

With regard to anxiety specifically, over the time period women subjected to work requirements experienced a 17.8 percent relative increased risk compared with a baseline of 5.8 percent, while men saw a relative change of 24.3 percent over a baseline probability of 5 percent. However, the rate of increase among men was more gradual than that of women. 

The threat of losing SNAP benefits could worsen already-existing mood disorders among enrollees, which could lead to an uptick in mental health services used, authors explained. In addition, those with undiagnosed or untreated conditions might be prompted to visit a provider in search of an exemption for work requirements.

“We found that women were impacted much earlier by work requirements compared to men, in line with a host of studies that have documented an association between food insecurity and poorer mental health outcomes among women,” authors said. 

Women are also overrepresented in SNAP programs, as they tend to play a bigger role in securing food for their families.

“Half of non-working women have reported that childcare/family obligations contributed to their employment decision. Women are also more likely than men to have part-time work, limiting their eligibility for a policy exemption,” they added. 

Citing previous research that shows work requirements do not yield large employment gains and actually reduce SNAP participation among vulnerable populations, researchers concluded “policy makers and future research should seek to better understand these tradeoffs when considering the net impact of SNAP work requirement policies on an already-marginalized population.” 


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