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.
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.
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?