Barriers to Mental Health Treatment

Examining the barriers people encounter when seeking mental health treatment and the issues that keep them from getting help

When you sprain your ankle or can’t shake a nasty virus, making a trip to the emergency room, or your doctor’s office seems obvious, at least if you’re fortunate enough to have the health insurance or financial means to do so.

What about when you can’t get a decent night of sleep for weeks at a time? Or when you feel too depressed to successfully complete a day’s work? Who do you call when you fear alcohol is becoming too much of a crutch in your daily life?

One in 5 individuals faces a mental health illness or crisis each year. One in 25 faces serious mental illness (such as schizophrenia or bipolar disorder). And more than half of these individuals do not receive the necessary treatment. That leaves 27 million Americans per year going untreated for mental health issues. That is an astounding number and certainly cause for concern. ⁽²⁾

Untreated mental health issues or illnesses can lead to further problems for the individual, their family and loved ones, and our society. Struggling with mental health makes everything more difficult. School, work, and interpersonal relationships will all start to suffer as a result of poor mental health.

When one person struggles, so do their immediate circle. Family, loved ones, co-workers, and acquaintances will all feel the effects sooner or later. It truly is in each of our best interests to prioritize mental health for ourselves and the world around us.

Untreated mental health conditions can and will lead to:

Increased risk of physical illnesses such as diabetes or cancer
Shorter life expectancy
Lost income
Higher rates of disability and unemployment
Lower overall life satisfaction
Higher risk of suicide (5)

Knowing what we know, how is mental health not a higher priority for our nation? What are some of the barriers to seeking out the mental health care that we so obviously need?

These are very good questions with complicated answers. Let us examine some of the biggest obstacles to seeking out mental health care as individuals and as a nation.

Lack of Awareness and Education

Mental health includes our psychological, emotional, and social well-being. Where we lie on the scale of mental health affects our thoughts, feelings, and actions. Poor mental health is not the same thing as having a mental illness, but untreated mental health problems can eventually lead to mental illness.

In school, we are taught basic health and hygiene. We are taught the rudimentary aspects of a nutritious diet. We learn about sex in terms of preventing STDs and unwanted pregnancies. There may be the occasional lesson in how “drugs and alcohol are bad” and why we should avoid them.

What we are not taught is that our physical and mental health go hand in hand – that what we eat affects our brains’ efficiency. We aren’t shown what a healthy relationship looks like in sex ed (how ironic!). We don’t discuss the emotional distress that sometimes leads to drug and alcohol misuse.

It’s tough being a kid or teenager; we have all these emotions and feelings that we don’t necessarily have the language to explain or describe – and no one is teaching us!

Talking about feelings needs to be normalized, and the younger we start, the better. Emotions are an everyday part of life, yet from a very young age, we are encouraged to “walk it off”, “let it go,” and “just ignore” the people who are giving us grief.

Stifling the expression of our emotions to make the people around us more comfortable is absolutely normalized, and therein lies a huge part of the problem.

How can we verbalize our struggles when we don’t even have the language to do so? How can we ask for help if we’re unaware that we need it?

It should be said that things are changing. People are speaking more openly about their mental health struggles, and slowly but surely, the stigma of mental health struggles is diminishing. We still have a long way to go through, and it begins with basic communication.

We need to start having tough conversations before there is a crisis. Parents and adults need to be role models by openly discussing feelings and emotions and how to deal with them.

Our children need to be taught the language of emotions; how to name them, when it’s ok to act on them and when it’s not. They need to be taught how to ask for help when they feel overwhelmed or out of control. The sooner we can address our mental health issues, the less likely they are to turn into a full-blown crises.

Stigma and Shame

Most people who live with mental illness have, at some point or another, been blamed for that illness, a thing they have no control over. They’ve been told it was “a phase” or something they could overcome if they just tried hard enough.

This attitude does not necessarily stem from cruelty, but rather a lack of understanding, education, and awareness.

Stigma creates shame in those who are suffering from something that is not in their control. Stigma and prejudice prevent countless numbers of people from reaching out for the help that they need in order to manage their mental health symptoms.

Here are some ways that you and your loved ones can combat the stigma that surrounds mental health struggles:

Speak openly and candidly

Speak openly and candidly about your own mental health. If you are a parent or teacher, be open with your kids about tough emotions. If you’re having a bad day and are feeling grouchy, explain that to them. Let them know that it’s ok to feel “sad,” “mad,” or “worried.” Normalize casual conversations about uncomfortable emotions. Teach them by example that sometimes, just talking about negative emotions can help to alleviate them.

Educate yourself and others

Educate yourself and others whenever you see an opportunity to do so. If you hear someone making a rude remark about someone’s mental health struggles, gently intervene and remind the speaker that mental illness is an illness – it doesn’t define a person, and it isn’t something that they can control. If you live with a mental illness and feel comfortable doing so, speak openly about your experiences. Do this in order to remind people that you’re just a regular human being who happens to live with challenges that are a little different than what they’ve seen before.

Use concise language

Words are incredibly powerful; they can be used to build someone up or tear them down. We tend to use mental health terms too colloquially in our culture. “I’m so OCD when I clean my closet,”; “I’m so depressed I could kill myself”, and “I drank like an alcoholic last night.” Casual use of serious mental health terms can be problematic. It diminishes the seriousness of the issues and may inhibit people from coming forth with their struggles.

Mental and physical illnesses deserve equal compassion and understanding

We don’t expect someone with heart disease to just “get on with it” the way we do when someone is too depressed to leave the house. Many mental illnesses are diseases, just like cancer and diabetes. We need to think about the comments we make and the preconceptions we have, and if in doubt, do some research and ask some questions to better understand the nature of various mental illnesses. Whether an illness is mental or physical, people deserve compassion.

Be honest about treatment

Be honest about treatment if you’re in therapy or counseling. We don’t feel embarrassed or ashamed about going to the dentist, or our primary care physician for a check-up, so let’s normalize “check-ups” or therapy for our mental health as well.

Be aware of self-stigma

Mental illness is nobody’s fault. Everyone’s body is different, and so are their minds. People handle challenges in different ways, including mental health challenges. You do what’s best for you and do it proudly and unapologetically. You don’t owe anyone an apology for struggling with your mental health, but you do owe yourself compassion, acceptance, and a pat on the back for proactively taking care of yourself.

Financial and Logistical Barriers

The Affordable Care Act requires medical insurers to provide behavioral and mental healthcare, but services can still be costly and difficult to find.

An ongoing mental illness, such as major depression, can cost upwards of 10 thousand dollars a year. A 60-minute therapy session can cost anywhere between 65$-250$. Sadly, a lack of financial resources prevents many people from ever seeking out the help they need.

Money isn’t the only barrier to mental healthcare. People must also contend with the following:

Long wait times

94 million Americans wait over a week for mental health services. This may not seem terrible, but for each day of wait time, 1% of patients give up on seeking treatment. And many people wait much longer than a week.

Shortage of providers

There is a rapidly increasing shortage of mental healthcare providers. Finding the right provider, who takes the right insurance, that is a good fit for the individual’s needs is becoming more challenging by the year. More providers are retiring than entering the field.

Language barriers

Mental healthcare relies quite heavily on verbal communication, and the U.S. doesn’t exactly prioritize multilingual learning. Non-English-speaking individuals seeking out healthcare (of any kind, really) are more likely to face treatment delays, misdiagnosis, and inadequate care.

Complex healthcare systems

Just navigating between insurance companies and care providers can feel like a full-time job. Many Americans have no idea when, where, or how to even begin the arduous process of seeking out mental healthcare. (7)

Racial Barriers

84% of U.S. Psychologists are white, 70% of social workers are white, and 88% of mental health counselors are white.

White adults are most likely to receive mental healthcare at 23%; 13.6% of Black people and 12.9% of Hispanic people are likely to receive treatment.

People aren’t as open to seeking out help when they suspect their doctors or other care providers can’t or won’t emphasize with their cultural differences and experiences.

This is particularly troubling since:

15% of African Americans, 13% of Latinos, and 11% of Asian Americans report feeling that they would have received better mental healthcare if they were White.
31% of White children vs. 13% of children from diverse racial and ethnic backgrounds receive mental health services.
16% of White adults receive mental healthcare vs. 8.7% of Black adults.
88% of Latino youths have unmet mental health needs, compared to 77% of Black youths and 76% of White youths. (8)

There is Hope

In June of this year, the U.S. House of Representatives passed the Restoring Hope for Mental Health and Well-Being Act. (10)

It is a welcome (if overdue) response to the nation’s ongoing and increasing mental health crisis. The act specifically addresses our record levels of overdose and suicide deaths, our increasing child and adolescent mental health crises, and the adverse psychological effects of the Pandemic on the mental health of Americans.

While it is reassuring to see our government take decisive action toward addressing the nation’s increasing mental health crises, it’s important to remember that significant change starts with each one of us as individuals.

It is up to each of us to educate ourselves, our children, our loved ones, and our neighbors with open minds and open hearts. Legislature is well and good (and very much needed), but compassion, empathy, and awareness from those close to us go much further to uplift and support the individual who is struggling. Feeling alone and misunderstood makes things worse. Feeling valued and accepted even at our lowest points makes it easier and more likely that we will reach out and gather the support and resources that we need.

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