Mental health awareness has increased dramatically in recent years. More people understand that therapy isn’t just for those with debilitating mental illness, and conversations surrounding anxiety, depression, and stress enter popular discourse more frequently these days. Nevertheless, even with such awareness, many people do not seek professional help who could otherwise benefit from it. The chasm that exists between recognizing such support is available and reaching out—and the reasoning behind it—is significantly pronounced, and the reasoning behind it is crucial.
Few reasons exist that justify avoiding therapy, and some exist more black and white than others. Many others are part of a web of logistical concerns, emotional barriers, and ingrained perceptions about what it means to get help. Some barriers are easier to work through than others, but all need acknowledgement to break down.
The Stigma That Won’t Go Away
While societal stigma surrounding mental health is less evident than it used to be, it’s still more than present. People fear being seen as weak, not capable of performing his/her/their job, or not hireable if they admit they are struggling. These fears come out in varying levels based on profession, socioeconomic status, community, and more—some areas are so antiquated that they still view mental health struggles as character flaws instead of comorbid health issues.
Men, in particular, are more likely to avoid help. What it means to be masculine in a socially constructed form presents a way that they should be—admitting vulnerability presents weakness. The misguided quality of a real man can handle his problems on his own no matter how much he feels otherwise on an emotional level runs deep—it is believed it’s bred into them. Women, on the other hand, need to explain away why they’re sad instead of being perceived as dramatic in their emotional outbursts, or assumed to be overly emotional when trying to seek help.
Practical Considerations That Seem Overwhelming
Cost presents a primary concern that clouds rationalization. Therapy costs money—extremely substantial amounts—and insurance copays with deductibles still seem too much. People living paycheck to paycheck assume therapy is a privilege, not a right—even if in the moment they’re feeling wronged by mental illness. It’s a cost/benefit analysis that determines whether one pays for therapy or at least puts food on the table—and at least for now, ignoring health-related matters gives them the answer they seek.
Finding a provider who takes insurance, has availability, and feels like a good fit takes time and effort. When someone is already dealing with anxiety or depression, navigating phone calls, insurance verification, and waitlists can feel impossible. It’s exhausting work at a time when energy is already in short supply. Working with a Denver therapist or counselor elsewhere often means persistence through this initial process, which is exactly what mental health struggles make difficult.
Time is another real constraint. Between work, family obligations, and everything else, finding a weekly hour for therapy sessions can seem unrealistic. Telehealth has helped with this by eliminating commute time, but the scheduling challenge remains for people with inflexible jobs or caregiving responsibilities.
Fear of What Happens in Therapy
For those who’ve never gone, fear of the unknown is intimidating. What are they going to ask? Are they going to make someone relive trauma? What’s worse, is therapy going to make someone feel worse before it gets better? Such fears are not unfounded, either; legitimate, trustworthy therapy requires some digging up—and sometimes making someone more upset is the only way to get them through the hardest parts.
Other fears concern how one will feel judged or misunderstood. It’s not easy to open up to a stranger about bad decisions and embarrassing feelings. The thought that a therapist might look down on someone keeps people from making that first appointment—with the understanding that they believe therapists haven’t heard everything—when in reality, while no one therapist generalizes their clients, they’ve heard everything else through practice.
The fear of losing control is also helpful; people feel that once they’ve divulged their problems, they might get projected onto, diagnosed (negatively), or interpreted into something that wasn’t intended. When one prides themselves on their independence and self-reliance, giving up any kind of personal responsibility—even to a pro—feels threatening.
Cultural and Familial Considerations
Cultural differences drive how people view mental health in general as well as what is appropriate treatment. In some cultures, familial problems stay in the family; outsiders need not intervene—it will bring dishonor and shame—or even viewed through an allocation of values as medicalized issues, mental health is a personal failing instead of something more spiritual and sociocultural.
Family members matter—they either grew up with family dynamics that offered vulnerable discussions quite easily and now feel they’ve betrayed their family members by seeking counseling or had therapy mocked with demeaning attitudes that stick hard even when critical thinking comes into play later on in life.
Religious considerations complicate this further; some church communities advocate prayer and support over diagnosis and professional help, leading some people to believe that they should support themselves through faith instead of science. Sometimes professionals can’t be found who account for religions; other times, people fail to realize those options exist in the first place.
Overcoming Barriers
While understanding these barriers does not instantly remove them from the equation, it’s easier to face them once they’re normalized. Many barriers have logistical solutions—i.e., sliding scale fees, employee assistance programs, online resources create access; community mental health workshops provide real-time access for anyone else without charge.
Internal factors are harder to get rid of—for example, objectively looking at what it means for a person seeking help or what societal critiques tell them culturally when it’s against the person who needs help.
The decision to start therapy is rarely easy, but it’s also rarely regretted. Most barriers, while real, are ultimately surmountable when weighed against the potential benefit of getting support that genuinely helps.
