Therapy is a wonderful way to tackle life's challenges, whether you're dealing with grief, relationship issues or mental illness. But sometimes going to therapy is easier said than done. Luckily, identifying certain barriers to mental health treatment may help you better access the care you seek.
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Financial concerns are cited as one of the most common barriers to therapy, according to June 2021 research in SSM Population Health. Sessions can sometimes cost more than $200 a pop, per the National Alliance on Mental Illness (NAMI), so it's no wonder it can be difficult to pay for ongoing care.
But budget isn't the only factor that can bar access to mental health support. Here, we talk to Nawal Alomari, LCPC, a Chicago-based therapist and life coach, about overlooked barriers to therapy (though this list is by no means exhaustive) and what to do if you face them.
If finances are a concern, talk to potential therapists about whether they offer sessions on a sliding scale, which may help make care more affordable, per the NAMI.
Though this isn't always the case, people assigned male at birth (AMAB) and those who identify as men tend to face more societal stigma when it comes to taking care of their emotional wellbeing, Alomari says. For instance, they're often conditioned to act "tough" and avoid talking about feelings.
And these arbitrary social expectations can have a very real effect on whether or not someone feels comfortable seeking care, Alomari says — if you've been trained not to reveal or explore your emotions, diving into therapy may feel extreme or off limits entirely.
Indeed, people AMAB are less likely to seek therapy than people assigned female at birth due to this stigma, despite higher rates of mental health-related problems like suicide and drug misuse, according to an August 2020 article in the American Journal of Men's Health.
Your cultural background — like your ethnicity, religion or geographic location — is another potential barrier to mental health treatment. For instance, some communities may consider it disrespectful to talk to a stranger about personal issues like family conflict or religious doubt, Alomari says, and fear of overstepping this cultural boundary can understandably discourage people from getting the help they need.
If your culture is a big part of your identity, you may also be concerned that a therapist from a different background won't understand your experience or where you're coming from. This worry is legit, Alomari says — after all, you want to feel heard, respected and be appropriately advised by your practitioner.
And while therapists are often trained in cultural competency and it's possible to specifically search for counselors that share your background, the fear of cultural insensitivity can dissuade some people from taking that first step.
Similarly, how you're raised can influence your ability to get mental health care. For example: "If you're taught at home to hold back your tears and don't talk about how you feel, to ignore that fight you just had, that stress isn't a thing — you're going to be a lot less likely to want to go get help from somebody else," Alomari says.
In other words, it's possible to internalize mental health-related stigma that you were taught as a child, which may affect whether or not you feel comfortable going to therapy (or even realize it's an option in the first place).
Therapy may help you unlearn some of this stigma, Alomari says: "Just like you go to a doctor for illness, you should go to a doctor for a mental health struggle." A therapist can also help you set boundaries with your parents moving forward.
You can experience challenges at any stage of life. Unfortunately, though, age can be a factor that affects your ability to access mental health care.
For instance, older adults are the least likely population to seek mental health care compared to any other age group, according to the American Psychological Association (APA) — and that's despite their being at increased risk for depression, per the Centers for Disease Control and Prevention.
In contrast, younger generations like millennials and Gen Z are more likely to have gotten mental health care than those in the Gen X and baby boomer groups, according to the APA.
Children and teenagers may also have a trickier time accessing care, as parent or caregiver involvement is often necessary, Alomari says. Kids may have trouble getting treatment because of a parent's aversion to therapy, lack of insurance or difficulty getting to and from appointments, for instance.
School is a good place to start if you're under age 18 and unsure how to access therapy, according to the NAMI. Talk to your school counselor or college health system about free or sliding-scale care.
How to Overcome Mental Health Care Barriers
Of course, these barriers to therapy are often ongoing and won't just disappear. But these tips from Alomari may help bring mental health care a little closer to your reach.
1. Keep It Private
Just because you want or are going to therapy doesn't mean you have to tell people if you don't feel comfortable doing so, Alomari says. Getting the care you need is most important, so if keeping your experience to yourself for now is the safest decision, you can do that.
And remember: "Whoever judges you, that's more about their own biases towards therapy than it is about your mental health or your value as a person," Alomari says.
2. Try Teletherapy
One way to keep your therapy experience private is by opting for teletherapy, because you can do a session when and where you feel the most comfortable, Alomari says.
"[Teletherapy] provides access for people who don't want to explain to their partners, parents, kids or roommates where they're going — they can do therapy in their car or rooms and speak privately," she says.
It's also provided an opportunity for kids whose parents may not otherwise be able to transport them to a therapy session, Alomari adds.
3. Shop for Therapists
Overcoming your personal barriers to mental health treatment may also be more manageable if you find a therapist that understands your background and how it influences your ability to access continued care.
For instance, a therapist that specializes in gender-affirming care may be a good fit depending on your gender identity. A counselor with a similar cultural background may likewise be able to provide support and resources tailored to your situation, Alomari says.
And if you're worried that working with a practitioner of a similar background could reinforce community-based or cultural stigma, here's Alomari's take: "Don't assume that someone might judge you because they're from your community. We're trained to understand what you're going through and to support it — we want to help."
That said, don't feel pressured to stick to the first therapist you speak to. It's normal to shop around for therapists before settling on someone you click with, Alomari says. "It's OK to test somebody out and see if you feel understood or not. And if you don't, listen to your gut and try somebody else — don't get discouraged."
- SSM Population Health: "Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study"
- American Psychological Association: "Stress in America: Generation Z"
- American Journal of Men's Health: "Males and Mental Health Stigma"
- National Alliance on Mental Illness: "The Doctor is Out"
- National Alliance on Mental Illness: "Strategies to Afford Mental Health Treatment"
- National Alliance on Mental Illness: "4 Ways Teens Can Access Therapy Without Health Insurance"
- Centers for Disease Control and Prevention: "Depression is Not a Normal Part of Growing Older"