One of the unifying themes of people who have made out particularly poorly in the modern United States is that a lot of them are people who won't, or can't, ask for help.
The very strong instinct of the American legal system, the American political system, American economic thought, and American culture is that people, especially adults, know what is best for them and will ask for help when they need it. Trying to help people who won't ask for it is considered an affront to their dignity and autonomy, and is likely to be counterproductive.
But, it is hard to believe that it is really that simple.
There are woman and children who experience abuse in their homes, but won't leave and won't cooperate with authorities who try to punish the abusers, or outsiders who try to get them to leave.
There are girlfriends and wives who fall in love with and rely on men who deal drugs or commit crimes, and don't know how to leave when they start to be drawn into the activities where they end up being the scapegoats who are punished harshly because they have no ability to turn in others whom they don't love more than themselves in exchange for leniency.
There are a lot of exploited illegal aliens and runaways, who know that they are being used and mistreated, but are adamantly opposed to going back to what they have fled. They don't think there are any alternatives, and sometimes, they are right.
There are foster children and former foster children who have nobody they can trust whom they can turn to, and aren't in one place long enough to develop ties with people they could come to trust, when then are mistreated or make a little mistake that causes their fragile survival system to collapse.
There are chronically homeless people who sleep in the rough on the streets, in alleys and entryways, over steam grates and in parks and riverbanks and underpasses. But, they aren't willing to stay in a shelter, even though many of those people each year die, suffer head trauma, and suffer hypothermia in winter and heat stroke in summer. They don't want to be there, but they haven't found a satisfactory alternative and don't know how to make one.
There are drug addicts who are addicted, tied to black markets full of dangerous criminals in order to feed their addictions, who are watching their lives fall apart. But, they can't summon the will to change and wouldn't know what to do if they could.
There are alcoholics who don't have to resort to black markets, but still lack the will and the knowledge they need to do something different as their lives, their jobs, their families fall apart, sometimes profoundly, and sometimes incompletely so that they can persist in their impaired state for a long time.
There are people with mental health conditions and developmental disabilities who need help managing their lives and their conditions, but by virtue of those conditions have trouble navigating the complex bureaucracies that can offer what little assistance is available. They are forced to act as advocates in a system designed for middle class people in good mental health with physical illnesses, but bureaucratic competence who have family to help them navigate the system.
There are senior citizens who never asked for help before and don't want to change that proud record now, even though they can't physically or mentally cope with daily life in a home established around the needs of a pair of middle aged able bodied adults, as their bodies and minds decline with age. They aren't very comfortable with computers and smart phones, but it is increasingly hard to get anything without using them.
There are veterans who were masters of the world, competently wielding advanced equipment and taking other people's lives with impunity, who return home with many skills that have little relevance to the civilian world, with instincts about how to interact with people that work less well in civilian life than they did in the military, and who not infrequently come back with both visible physical injuries and scars, and invisible injuries like traumatic brain injury and PTSD, and with mental scars even among those who haven't suffered any clinically diagnosable impairment. They've been taught to be tough and endure pain and trauma because that's what you need to do in order to survive in war, but this also creates internal psychological barriers to seeking help that is reinforced by the attitudes of your fellow service members while you serve, and by other veterans once your service ends.
There are people in poor, black and brown neighborhoods who learn that a call to police will often lead to police responses that affect the innocent, that lead to excessive uses of force, and that lead to abuses of the criminal justice system that discriminates severely against people who can't post bond and can't hire a private criminal defense lawyer.
There are jail and prison inmates who are being abused by fellow prisoners or guards with nowhere to turn which can provide effective protection but prison gangs that extract their own cruel dues and prevent them from returning to ordinary society.
There are people released from prison and jail who want to turn their lives around, but have gangs they were forced to join at some point before pressuring them, who don't have educational credentials or marketable skills or social capital who need to find a job to support themselves and stay out of trouble on a very tight timeline, who have forgotten how to live a straight civilian life if they ever knew after years in situations where different tactics were key to survival. But, if they admit that they aren't able to meet the demands imposed on them to a probation or parole officer, they are at grave risk of ending up behind bars again.
There are children in school, young adults in college, and adults at work who are bullied or sexually harassed or abused, who learn that their efforts to seek help from the people in authority often backfire and end up doing them more harm than good if the bullies can't be removed from the situation.
There a bright young people in failing inner city or rural schools from poor families who don't do what it takes to go to college, and either don't go to college or don't pursue the programs that would allow them to realize their greatest potential, because no one in their world is giving them default options that put them on that track, and their personal lives create missteps that thwart their academic performance, and they are terrified of incurring student loans that will be a burden on them and their families like the many people who tried to take that route and failed that they know.
There isn't a single solution. The details of the right way to make people aware of better alternatives, to create better alternatives where they don't exist, and to empower people to ask for help, differ for each of these groups of people. But, the class of problems in which people who don't or can't ask for help are suffering is pervasive, and while the details differ, often analogous strategies and problem solving approaches have wide applicability to these circumstances.