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One in five people in the United States face mental health challenges every year, with effects that ripple across every area of their lives. Although high-quality treatment can help mitigate those effects, less than half of people who need care actually get it due to persistent barriers to mental health treatment.
This low utilization of mental health services means many people are left untreated, raising the risk that their symptoms will get worse and their quality of life will diminish. Untreated mental health conditions can have far-reaching effects, including:
- Increased risk of physical illnesses such as diabetes or cancer
- Shorter life expectancy
- Lost income
- Higher rates of disability and unemployment
- Lower overall life satisfaction
When employees lack access to needed mental health care, they’re less likely to work effectively and more likely to seek pricey medical care that may not address their needs. Employers bear the financial weight of inadequately treated mental health conditions, often without realizing it. For example, NAMI reports that depression is a leading cause of disability worldwide, and one in eight visits to U.S. emergency departments are related to mental health disorders.
10 common barriers to mental health treatment
One important step toward a mentally healthy workforce is understanding the barriers to mental health. Identifying and addressing challenges early on helps people feel better faster, with less negative impact on their lives. Here are some common barriers to treatment for mental health:
1. Lack of access to mental health care
Mental health care is often hard to get. In a recent study of over 50,000 people, 95 percent reported at least one barrier to accessing mental health services. Challenges with access to mental health care can include:
Long wait times
One study found that 94 million Americans have had to wait longer than one week for mental health services. One week may not sound bad at first, but for every one day of wait time, 1 percent of patients give up seeking care altogether. And for many, wait times are much longer.
Shortage of providers
Another challenge is finding a provider that specializes in the right type of care for their needs and takes their insurance. There is an escalating shortage of mental health professionals, especially since there aren’t enough new providers replacing the number who retire every year.
Finding a culturally responsive provider is even harder. Racial and ethnic populations only represent one-sixth of psychologists, even though these communities represent closer to 40 percent of the U.S. population.
Language barriers
The United States’ relatively lax attitude toward multilingual learning means it also can be difficult for non-English speakers to find providers who are fluent in their language. Since mental health care relies heavily on verbal communication, this barrier to accessing mental health services can lead to treatment delays, misdiagnosis, and inadequate care.
Lack of transportation
Transportation can be a logistical barrier to therapy. When people can’t physically get to a mental health appointment, they’re less likely to get timely care or access needed medications, and more likely to miss appointments. Lack of transportation disproportionately impacts those with lower incomes and who lack insurance.
2. Poor care quality
Accessing mental health services is hard, but finding high-quality care is even harder. Only 20 percent of mental health treatments have been proven effective in research, according to the American Psychological Association (APA). In addition, traditional mental health care services don’t often measure or provide insight into the outcomes of various care types for different conditions. High-quality mental health care exists, but it requires knowledge and persistence to find it.
3. Stigma
Stigma—the fear, embarrassment, or shame associated with needing mental health support—is a major barrier to receiving mental health care. As a result of stigma, eight out of 10 workers won’t reach out for support, often for fear that their reputation, relationships, or job status could be in jeopardy if they disclose having a mental health condition. This can worsen their symptoms and make them less likely to get treatment and recover. Former U.S. Surgeon General Jerome Adams, MD, called stigma “the biggest killer out there.”
4. Complex health care systems
Navigating insurance coverage and the health care system can be confusing and time-consuming. Research suggests that many Americans lack access to information that builds mental health literacy, which makes it difficult to engage in treatment or know when, where, or how to seek it.
5. Distrust toward the mental health system
Research shows some people don’t seek care because they lack confidence in mental health treatment or feel it won’t help. Others are afraid they’ll have to take medication or be placed in a psychiatric hospital. Concerns about confidentiality are also a barrier to treatment for mental health for some.
Black, indigenous, and people of color (BIPOC) may have additional feelings of distrust toward the mental health system that make it difficult to seek care. Research shows the majority of psychologists in the United States (86 percent) are white. Paired with historical and contemporary instances of systemic oppression, this results in an understandable fear of being vulnerable to white people.
6. Preference for self-help
In one survey, people voiced a preference for managing mental health challenges on their own as well as thinking they didn’t need treatment. Self-help can reduce stigma and help address some mental health concerns, but is not a replacement for professional mental health services.
7. Preference for informal sources of help
Some people report feeling more comfortable asking for mental health support from friends or family, or turning to prayer or pastoral counseling as a replacement for therapy.
8. Financial barriers to mental health care
Even if someone has access to mental health care and wants treatment, financial considerations might prevent them from seeking help. One study found that lack of affordability was one of the most prevalent barriers to mental health care access, and one that caused considerable worry among those who need these services.
Many people lack health insurance. Even among those with health insurance, many are forced to use out-of-network benefits to cover mental health care, which leads to higher out-of-pocket costs compared to other types of care. In spite of legislation created to prevent financial barriers to mental health care, insurers often pay lower rates to mental health providers than other medical professionals, so fewer therapists and psychiatrists can afford to accept insurance. One study found that only 20 percent of mental health practitioners accept insurance.
Financial barriers to mental health care are especially pronounced among low-income workers. One survey found that nearly half of people making less than $30,000 annually say they have access to affordable mental health support, compared to 76 percent of those making more than $150,000. In that survey, low-income workers were twice as likely to put off mental health care because of the cost, and nearly a third turned to self-medicating to cope with stress.
9. Lack of mental health policy
Mental health has received increased attention in recent years, but this hasn’t translated into an increase in quality services, according to the World Health Organization’s (WHO) Mental Health Atlas report on worldwide mental health services. The WHO added there is a shortfall in terms of leadership, governance, and financing for more promotion and prevention efforts.
10. Systemic racism and lack of culturally responsive care
Documented abuses, inequities, and oppression—past and present—have led some people of color to lose trust in health care providers, including mental health professionals. Studies show people of color more often receive lower quality mental health care than white people. As a result, BIPOC individuals often don’t receive the mental health support they need.
Another barrier to receiving mental health care for underrepresented communities is a lack of cultural competence among mental health providers. These are skills that lead to effective and appropriate communication with people of other cultures. Cultural competence allows people to feel comfortable with their provider, which encourages them to continue receiving care.
How employers can help remove barriers to mental health
While several barriers to mental health treatment are outside employers’ control, there is a great deal organizations can do to support workforce mental health. Here are a few ways to demonstrate your commitment to improving access to mental health care and breaking down barriers:
Invest in mental health benefits
In today’s workplace, a baseline investment in an EAP, health plan, or mental health app isn’t enough. With these approaches, low utilization, long wait times, and other barriers keep people from accessing mental health services. Instead, companies are choosing more comprehensive mental health solutions that include:
- Support for the full spectrum of mental health needs, from day-to-day stress to depression, anxiety, and more complex conditions
- Culturally responsive care from diverse providers who understand and adapt to different cultures’ varying mental health needs
- A commitment to care approaches that have been researched and tested, with data to prove results
- Technology that improves access to mental health care through video, telephone, live chat, and in-person options
Investing in mental health pays off. Most employees (84 percent) say that when considering a new job, it’s at least somewhat important that the prospective employer offer mental health benefits. When employees feel their companies support their mental health, they’re less likely to experience symptoms of mental illness, miss work, or underperform. They’re also more likely to talk about mental health concerns, feel satisfied with their job, and feel proud to work at their company.
Build a healthy work culture
Be intentional about how you design your team’s work and your workplace culture, so you can create an environment that supports mental well-being. For example:
- Give employees flexibility in how they structure their day or where they get their work done
- Encourage employees to approach their supervisors if expectations or workloads become difficult to manage and commit to finding solutions together
- Model healthy behaviors by using paid time off (PTO) and talking about how you make time for self-care
- Accommodate PTO to focus on improving mental, not just physical, health
- Adopt company policies that reflect employee mental health needs and provide outlets for expressing concerns and asking for support
- Foster a culture of connection by implementing support groups, employee resource groups, and informal opportunities for socializing
Proactively combat stigma
Employers play an important role in destigmatizing mental illness. Some of the steps you can take include:
- Encouraging managers and company leaders to talk openly about their mental health, which helps others feel more comfortable opening up as well
- Talking about mental health on all-company calls
- Doing regular check-ins and surveys, and following through with meaningful action based on the findings
- Developing anti-stigma campaigns
- Forming a team of “mental health champions” who build awareness and act as non-judgmental sources of support
Provide training for managers
Many employees assume their managers are receiving training on identifying mental health issues and providing referrals to helpful resources. However, surveys suggest that just 25 percent of managers have actually received this type of education. Consider providing training in:
- Creating an inclusive, supportive environment so that everyone feels comfortable asking for help
- Educating all employees about mental illness and the resources available to them
- Listening to employees in distress and having empathetic conversations about mental health
Seeing the benefits
Barriers to mental health treatment have existed for decades, but through concerted efforts to destigmatize and address mental health conditions, change is happening. Employers play an essential role in improving mental health accessibility and breaking down barriers. And the rewards are well worth the effort when employees are able to thrive in both their personal and professional lives.
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