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5 barriers to mental health treatment and access to care

June 16, 2021
A female therapist addresses barriers to mental health and reaches her hand out to comfort a woman sitting next to her during a group therapy session.

In the United States, mental health issues are far more common than many realize. According to the U.S. Department of Health and Human Servicesone in five American adults has experienced a mental health challenge, and one in 20 Americans live with a serious mental illness such as schizophrenia, bipolar disorder, or severe depression.

Access to mental health care is crucial to helping many individuals receive the support required to address their illnesses. However, more than half of adults with mental illness in the U.S. (a total of 27 million people) do not receive the treatment they need. 

When mental health issues and illnesses go untreated, they affect a person’s ability to live a fulfilling life and manage school, work, or family responsibilities. Ensuring that individuals have access to mental health care can improve individuals’ lives and entire communities. Removing these barriers to mental health treatment can dramatically reduce or eliminate the risk of suicide, legal issues, family conflict, unemployment, and substance abuse. 

To help your public service agency understand and surpass these common challenges, let’s look at the top five barriers to mental health care and how we can begin to surpass them.

1. Financial barriers to mental health treatment

Although the Affordable Care Act requires medical insurers to provide coverage for behavioral and mental health care, the cost of treatment still limits access to mental health services. Mental health care services can be costly, even with insurance or financial assistance. Copays and deductibles add up quickly when a diagnosis requires regular therapy, complicated medication management, or intensive treatment programs.

For many individuals, a lack of financial resources prevents them from seeking help, leading to inconsistent or inadequate treatment. A traditional 60-minute therapy session can range from $100 to $200 depending on the state and whether the provider is considered in-network. Treating severe diagnoses can carry even heavier, lifetime cost burdens. A patient with major depression can spend an average of $10,836 a year on treatment. 

2. Lack of mental health care professionals and services

One of the main barriers to mental health treatment is a lack of available services caused by a combination of a high demand for treatment and a low supply of trained professionals.

The U.S. is facing an overall shortage of doctors, and the shortage of mental health professionals is steeper than in any other medical field. According to the Health Resources and Services Administration, 149 million Americans (nearly half the U.S. population) live in federally-designated Mental Health Professional Shortage Areas. For comparison, 93 million Americans live in similarly-designated primary-care shortage areas, and 67 million live in dental health shortage areas. 

Rural areas in particular often have few to no mental health care providers, let alone providers with specific specialties. On the other hand, urban clinics and providers often have long waiting lists, and patients can suffer for months before getting a basic intake appointment. Finally, while virtual therapy is much more common and accessible for many, this option requires a reliable internet connection and can limit care if a person isn’t in a safe, trusted environment.

3. Limited availability of mental health education and awareness

Another common barrier to mental health treatment is the general lack of mental health education and awareness. Those who have the greatest need for mental health treatment often haven’t been taught about the signs of mental illness and how treatment can help.

With a physical injury or illness, the signs are easy to identify—you feel sick, something hurts, or a clinical test shows a tangible abnormality. Mental illnesses, however, manifest in ways that are harder to recognize. Symptoms are often subtle and sometimes dismissed as “personality” or “attitude” issues. For example, clinical anxiety may be dismissed as “worrying too much,” and depression can present as “laziness” or “fatigue.”

Serious conditions may not even be obvious to the person suffering or those around them, especially if they don’t share their thoughts and feelings. Other times, people may assume their emotional or mental status is normal, not realizing that they are suffering from disordered thinking or clinical symptoms. Ultimately, if a person doesn’t know something is wrong, they’re unlikely to seek treatment.

4. Social stigma of mental health treatment and conditions

A person’s own beliefs about mental illness can prevent them from acknowledging their illness, seeking help, or sticking with treatment. Studies have found that the stigmas associated with mental illness—defined as the “devaluing, disgracing, and disfavoring by the general public”—often prevent people from accessing treatment.

The risk of facing discrimination in cultural, social, and professional circles also creates a barrier to seeking treatment. People may fear that family and friends will avoid them or treat them differently after learning that they have mental health struggles or that disclosing a mental health condition will lead to adverse treatment and perceptions at work.

While these stigmas won’t disappear overnight, spreading awareness and education through national and local campaigns can help change public perceptions of mental health illness and break down those barriers to treatment.

5. Racial barriers to mental health care access and treatment

There are significant disparities in mental health care accessibility among different racial and ethnic groups. One survey finds that white adults (23%) are more likely than Black (13.6%) and Hispanic (12.9%) adults to seek and receive mental health treatment. In addition to the barriers discussed above, these disparities stem from issues like a lack of diverse representation in the mental health field, language barriers, and implicit bias from providers. 

According to research from the American Psychological Association and the Bureau of Labor Statistics, 84% of psychologists, 67% of social workers, and 88% of mental health counselors are white. People are less likely to seek help if they think their doctor can’t understand or empathize with their background, cultural differences, and experiences.

Fortunately, the American Psychological Association (APA) reports that more people of color are earning psychology degrees, a trend that is en­hancing the diversity of the psychology workforce and helps break down barriers to more equitable access and treatment.

Next steps: Removing barriers and making mental health care more accessible

While these barriers to mental health treatment can seem disheartening, it’s essential to take the time to understand how these issues apply to the communities and individuals your public agency serves. Understanding the factors that prevent access to mental health care opens the door to improving access with better programs and policies.

As the first step in this process, we recommend leveraging your case management software to collect meaningful data, assess your community’s needs, amplify your mental health programs, empower your community, and improve your impact.

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