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Why people don't get help for mental illnesses

May 21, 2019
Blog submitted by Angie Hughes, LCPC, and Ariel Swanson, LCSW.

One in five people struggle from mental illness.  Think of five people – including yourself – and think about what you already know about depression, anxiety, or another mental illness.  Now, think about how often you, or someone that you know who might be struggling has actually talked openly about getting help.  According to the National Alliance on Mental Illness (NAMI), nearly 60% of people who need mental health assistance do not reach out to get the help they need.  For others, it may take up to 10 years.  There are a number of reasons for not getting help, with the most prominent being stigma related to mental illness, cost associated with mental health treatment, and worry that it won’t be helpful.  Many people think they can manage it on their own.

What exactly is stigma?  Stigma is a negative mark, or some sort of derogatory note about something or someone.  Stigma comes from both internal and external sources.  Internal sources include our own thoughts.  It can be hard to admit you need help.  It may require significant changes in your life.  Denial can be so much easier than revealing these difficult issues with someone.  It can also bring up feelings of embarrassment and weakness as people often feel judged by others.  This often happens when people have a poor understanding of mental illness.  External sources are the things we hear and see from friends, family, and anything outside of ourselves.  How many times this week have you said or heard someone say, “They are nuts,” or “Don’t be crazy!”  Well, these are stigmatizing comments.  Too often we make comments of this nature without realizing the impact they can have on someone – even outside of the situation being talked about.  According to NAMI, people experiencing mental health conditions often struggle with bullying, discrimination and rejection.  That being said, if someone hears a stigmatizing comment, they are less likely to reach out for help – either professional or personal.

If someone has a broken leg, they get it fixed.  If a person has a cold, they take medicine to combat the infection.  If someone has depression… why don’t people get help?  One of the common responses to this is the cost associated with mental health treatment.  Too often the assumption is made that insurance won’t cover mental health treatment; however, most insurance providers do have some sort of mental health coverage.  Often there is a struggle to admit to feeling depressed or anxious, which prevents people from reaching out to insurance providers to determine coverage.  The Mental Health Parity and Addiction Equity Act of 2008 was put into place to require health insurers and group plans to provide the same level of benefits for both mental health and addictions treatment that they do for medical coverage.  It’s not perfect, though it is a great support!  Most employers also provide an Employee Assistance Program that will help people begin counseling services – or assist – in finding services.  It is also important to note that there are a number of people who do not have health insurance coverage.  Most agencies do have cash prices for services, billing services and/or sliding scale fees to make treatment more affordable, and individuals can participate in support groups usually at no cost. 

Finally, some people believe that treatment won’t be helpful.  These beliefs tend to relate back to thoughts of stigma and maybe even having had negative experiences in the past.  When a person is looking for a recommendation for a doctor, dentist, hair stylist, movie…other people’s opinions are taken into account.  That being said, if a person has tried therapy and didn’t mesh with a specific therapist – sometimes the entire agency gets lumped into that bad experience.  We live in a rural area with limited resources, especially mental health treatment.  As a therapist, I can speak to the point that it’s not realistic to think that every person I come into contact with will connect with me.  It’s important for people seeking treatment to recognize that too.  Be open with your therapist.  Tell them what you need and if it’s not a fit – then it’s not a fit – and they’ll do their best to help you find someone who you can mesh with.

Mental health is so important to our overall wellness.  Sometimes it can be scary and overwhelming when things aren’t going as expected, we don’t feel the way we want to and we don’t know where to start.  Start by speaking up. Start by telling someone that you’re not feeling well.  Start by asking for help.  A good place to start may be your primary care provider; share both your physical symptoms and your emotions and thoughts.  There are people that care, even when it doesn’t feel like it.  Don’t let the stigma surrounding mental health impact whether or not you get help.  Cost can be a huge factor, but contact some places to see how they can help you get help.  Contact your insurance to find out more about your mental health benefits.  Most importantly, don’t let the fear that it won’t work stop you from trying to get help for yourself and building a healthier and fulfilling life. 

Perry Memorial Hospital offers mental health assistance for a variety of ages.  The Family Health Clinic includes both pediatric and adult Telepsych services, and the Senior Behavioral Wellness program serves adults 65 and older who are Medicare-eligible.