Photograph by Audra Miton
In the early stages of motherhood, Tatiana Marie would often lay awake at night, plagued by a continuous cycle of piercing and exhausting thoughts (for privacy, we’re not using Tatiana’s last name). Stop your child from crying, her thoughts said to her. Stop your child from doing this, stop your child from doing that. And, sometimes: No, you don’t want your child no more.
Tatiana, 32, was in a precarious situation, unemployed and living in extended-stay motels with her two young children. She tried getting rental and housing assistance, calling phone numbers from pamphlets in her doctor’s office and various nonprofit organizations such as the Salvation Army. Time and again, she was told she did not qualify for aid.
“I’ve had shelters tell me that they don’t take non-dire situations,” says Tatiana. “Again, I was living in hotels with no income, with two children, but I was not dire enough when it came to my safety—aka, I wasn’t on drugs. I had to have paperwork from other institutions that said these things [like housing and income] were actually issues for me.”
For many American families, economic insecurity can spiral into a host of other issues. A robust body of research has found that extreme financial worries are a significant predictor of higher psychological stress, and living in poverty—considered a social determinant of health—poses elevated health risks, including mental health issues.
In Georgia, the impacts of poverty disproportionately affect Black communities, particularly Black women. About 18 percent of Black women in Georgia live in poverty, compared to 10 percent of White women. Centuries of systemic racism have also suppressed Black women’s earning potential: For every dollar a White man makes in Georgia, a Black woman earns $0.64, according to the Georgia Budget and Policy Institute.
About 18 percent of Black women in Georgia live in poverty, compared to 10 percent of White women.
Armed with a better understanding of the hazards of economic insecurity, social support organizations are increasingly exploring a new way to help struggling families: giving them cash. Guaranteed income programs provide families with no-strings-attached, regular cash payments intended to cover the minimum costs of living.
Tatiana’s mental outlook changed when she got involved with In Her Hands, a local nonprofit program, funded by the Georgia Resilience and Opportunity Fund and GiveDirectly, that delivers a monthly guaranteed income for two to three years to Black women facing economic insecurity.
Tatiana joined In Her Hands in 2022, after a representative for the project approached her at her apartment and urged her to apply. She was approved as part of the project’s first cohort. Over the course of two years, In Her Hands’ Phase One initiative provided 654 women with $20,400 each, supplied in regular payments averaging $850 per month. Phase Two of the program, now in its first year, will send $36,000 of guaranteed income across three years to approximately 270 women.
The extra cash didn’t solve all of Tatiana’s problems, but it helped enormously. The guaranteed, consistent income not only reduced her stress but also boosted her confidence levels, because she felt she could support her kids. When her thoughts tried to convince her she wasn’t doing enough, she eventually began to tell herself that she was doing quite the opposite.
“My kids were able to eat great,” she says. “If they needed diapers, I was able to buy it, and I felt so good. If they needed clothes, I was able to be like, ‘Add that to the shopping list at Walmart.’ I was able to get their clothes. They were sick for two months at one point; it felt so good (to go) get Motrin: Oh, I have the money for it—let me go get it.”
Once, while grocery shopping, she treated herself to a tube of lip gloss and found herself crying in the aisle: It was the first time in years she felt financially stable enough to buy something, free from guilt, that made her feel good about herself.
With In Her Hands, Tatiana was not faced with the kinds of hurdles she had faced when applying to other support programs; she didn’t feel she had to be “qualified” or share her life story to receive the care. The financial support from the program helped sustain Tatiana until she was secure enough to find better housing and regular employment; she now works as an import logistics specialist at Röhlig USA. She and her children, now nearly four and two years old, are living in a safe and comfortable townhouse in metro Atlanta.
Although a guaranteed income program was the boost Tatiana needed, it is not a one-size-fits-all solution, especially when it comes to addressing recipients’ mental health issues.
Photograph by Audra Miton
Such programs show promising results when it comes to financial security: Last April, In Her Hands released a report showing that its participants were 27 percent less likely to worry about running out of food than similar women not in the program and 40 percent less likely to say they couldn’t cover a $400 emergency; participants were able to set long-term goals like accruing savings and pursuing more education.
What’s less clear is whether these programs can meaningfully improve participants’ mental health. Research on this question is mixed. In a 2023 study, the Center for Guaranteed Income Research found that recipients of a cash assistance program in Ulster County, New York, reported more feelings of hope and agency and could spend more time with their families and on self-care.
But such progress was modest and may not be permanent: A recent University of Michigan study tracking a three-year program in Illinois and Texas found that cash assistance resulted in temporary improvements in mental health conditions and stress levels. Cash payments “did provide financial flexibility and freedom,” the report explained, and better access to medical and dental care could lead to physical benefits. But overall, the payments didn’t appear to significantly improve recipients’ mental health outcomes.
The complex nature of mental health makes it difficult to draw definitive conclusions. But there’s an intuitive connection between the financial floor built by guaranteed income and a sense of psychological safety, says Ben Hampton, a researcher of financial planning at the University of Georgia.
“If people kind of have enough guaranteed income to meet those basic living expenses—their food and their housing—then what kind of relief would that give people?” says Hampton. “If people just have that certainty of knowing, Hey, I never have to worry about being able to pay my rent or my food.”
Even with financial support, low-income Georgians face a host of barriers to better mental health, from stress around finding childcare to extensive work hours and—perhaps most critically—access to clinical support. According to a 2023 Milliman report, Georgia currently ranks 48th in the nation for its ratio of mental health providers to population: There is one mental health provider for every 596 Georgians. Cost is prohibitive, too, with the average 60-minute psychotherapy visit in Georgia costing $181 without insurance.
“If you don’t got money, you can’t get a therapist,” Tatiana says. “You gotta live with it.”
Tatiana did not use her monthly income for therapy, but she says her mental
health improved after other financial worries in her life were reduced. The “little push” by In Her Hands helped to restore her confidence.
Now that she’s safely housed and working a stable job, she says she doesn’t think about the program as much anymore. But, she says, “the fabric” of what In Her Hands aimed to achieve was successful.
“We’re not dire, but we’re just trying to climb up,” says Tatiana. “That’s all we need is someone to see we’re trying to just climb up . . . We’re trying to get up, and all we need is someone to just take away one of the stresses that we had.”
This story is published in partnership with Atlanta Civic Circle and The Carter Center Mental Health Parity Newsroom Collaborative. Libby Hobbs is a former Fink Fellow in the University of Georgia Cox Institute’s Journalism Writing Lab. The lab is part of the Mental Health Parity Newsroom Collaborative, a group of newsrooms that covers stories on mental healthcare access and inequities in the U.S. The partners on this project include The Carter Center and newsrooms in select states across the country.
This article appears in our August 2025 issue.
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Joe Reisigl
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