It seems to me that citizens have free access to the necessities of life - food, water, shelter, medical treatment, education, and the like, but they also have a wide degree of latitude in terms of how they choose to live their lives.
Raffi wasn't happy with her situation, but as you noted, she has her necessities. I think it's apparent that she's punishing herself, choosing to live in conditions she dislikes, because on some level, she believes she deserves it.
It also appears that people are free to refuse medical treatment, or mental health support in the case of Yvette Picard, which can create some gaps in the system, and the merits of which can be debated at length.