If someone thinks they are depressed, they can just easily go to the doctor and instantly get help, right?

In a dream scenario, this would be the case.

However, in reality, the situation is often much more complex. For many people, there are barriers to seeking care for mental illnesses (i.e. for depression).

 

Why does a significant portion of those in need of mental health services not seek treatment? There are an infinite amount of possibilities, but I will highlight some crucial ones which act as a barrier for many.

For one, some people do not perceive the need for treatment. They may not be aware that what they are experiencing is actually depression. They may think that they should be able to deal with their symptoms without professional intervention. The list goes on and on!

 

When addressing this question, there are 2 types of barriers to discuss: attitudinal and structural.

 

ATTITUDINAL BARRIERS:

Negative Attitudes Towards Treatments:

People’s emotions (i.e. fears) could rule their decision as to whether or not to seek treatment.

  • “The treatment will not help me.”
  • “I could become dependent on treatment (i.e. medication).”
  • “I could be hospitalized against my will.”
  • “I’ve had previous negative experiences.”
  • “I’ve heard about the negative experiences of others.”

Stigma Towards Those with Mental Illness:

  • Social Stigma: the stigmatizing attitudes of society towards mental illness
    • i.e. “People with depression are lazy.”
  • Self Stigma: when a person with mental illness internalizes stigmatizing attitudes
    • i.e. Thinking one’s depression is a result of weak willpower

 

Stigma is an important barrier to treatment seeking! Those with depression may have the idea that if he/she asks for professional help/takes meds, the family will be disappointed in them, their friends will judge them, etc.

 

STRUCTURAL BARRIERS:

Availability, Financial and Geographical Access, and Time and Convenience of Services

 

There can be SO many of these, so I will just list some of the top ones faced in the United States:

  • Lack of insurance/inadequate insurance
  • Cost of services (In one survey, 50% of participants identified this as a barrier.)
  • Lack of time
  • Inconvenient hours of services
  • Lack of transportation
  • For rural areas, services/providers can be hard to reach
  • For urban areas, the wait time may be too long or services could be located in areas which are not easily accessible

 

 

How to Overcome Barriers

In order to make treatment more accessible, both sets of barriers (attitudinal and structural) need to be addressed. Given that these are very different, they require different approaches in order to overcome them.

Overcoming Structural Barriers:

One approach to tackling structural barriers is improving financial access through laws. For example, the 2008 Mental Health Parity legislation mandated that insurance plans cover mental health & substance abuse treatment services to the same extent as physical health services.

Overcoming Attitudinal Barriers:

Fighting attitudinal barriers means educating the public about mental illnesses and fighting mental illness stigma. Public information campaigns have been used in order to address these barriers. Campaigns such as these have been carried out in several countries, including the U.S., Britain, and Australia. Such campaigns often aim to remove the stigma associated with mental illnesses and seeking treatment.

 

While work has gone into addressing these barriers, still much needs to be done. Which type of barrier do you think needs more attention?

 

 

 

Source: “Major Depression in the Population: A Public Health Approach” course, Johns Hopkins’ Coursera lecture: “Unmet Need for Care, Barriers, and Programs to Improve Access,” By: Ramin Mojtabai
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3 thoughts on “Barriers to Treatment

  1. I guess I’m biased from my particular experiences, but to me, the most important barrier to getting treatment is bad experiences with therapists. For example, some therapists have tried to just command me to feel better. At one recent appointment, I said, “My mom and I were close, but I have complicated feelings about things xyz that she did,” and she said, “You need to let it go.” Um, I had just brought it up, it’s not like I’d been monopolizing our sessions with it. Worse, when I’ve explained the these therapists that these kinds of experiences have upset me, they haven’t tried to help our sessions go better for me, but just doubled down on their harmful methods.

    I appreciate your post for showing that getting mental health treatment isn’t as simple as going to the therapist/psychiatrist and then automatically getting better soon. It’s complicated. Poor mental health treatment can make someone’s mental health even worse.

    Liked by 1 person

    1. I absolutely agree with your final statement! It is not enough to have access to just any mental health treatment. It should be QUALITY, HELPFUL treatment. Unfortunately, there is no magical tool to find out which therapist/psychiatrist is the perfect fit for you. I wish you the best of luck! I believe that with the right provider, treatment can be life-changing, and even in some instances life-saving!

      Liked by 1 person

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