3 Barriers to Mental Health Treatment

Have you wanted to get mental health treatment, but run into barriers that you couldn’t overcome?

Dr. Monica Johnson
5-minute read
Episode #388

This episode is based on various comments and questions that I have received from listeners about barriers to mental health treatment—whether those be personal or systemic. Consequently, I wanted to give suggestions around the top comments that I hear from folks on this topic.

Do I really need mental health treatment?

Let’s start with the question that I hear a lot: "Am I really that bad?" I’ve had listeners reach out, tell me about their experience, and then say “But, like, I’m fine, right? I don’t really need to come to therapy.”

There are many credible self-help resources available and there are many things you can do on your own. However, what I’ll say is, if you were concerned enough to ask me that question, there is probably enough going on that you may want to see a professional even if it’s only a handful of sessions. That way, you can get a proper assessment and be provided with treatment recommendations.

I knew this skateboarder in college who fell down attempting a trick and hurt his wrist. He avoided going to the doctor and kept skating. After a fair amount of peer pressure, he finally went to the doctor and was informed he had a hairline fracture and was given treatment recommendations. He ignored those suggestions and the hairline fracture grew into a major problem. I remember him complaining about chronic pain later on. Why do I tell you this story? To remind you to address the problem when it’s small!

There is a quote that I enjoy: “No one raindrop thinks it caused the flood.” I caution you to be mindful of your raindrops. If you find that there are buckets all over your house to catch the water leaking in, it might be time to get professional help.

What if I can't afford therapy?

Let’s get to the elephant in the room: money. I hear all the time about the cost of treatment and the personal and systemic factors that play into this barrier.

From a personal perspective, I have seen people who don’t believe they deserve to get better or invest in themselves as people. If you’re one of these folks, I would implore you to consider that this mindset is probably a foundational element of why you need to be in treatment. It’s not selfish to take care of yourself. Your well-being is not a detriment to society, it’s a win for all of us.

Another issue that will arise regarding money is the mishandling of funds. At times, I will talk to patients who may need to reallocate resources from various miscellaneous spending so that they can afford services. Are you the type that when—let’s face it, if—you check your balance statements, there are recurring subscriptions that you barely remember signing up for? Or you realize you didn’t cook a single meal at home last week? If you are willing to modify these habits, you might discover you can afford services. I once had a patient who was having difficulty affording their insurance copay and we discovered that by getting rid of some streaming services he wasn’t using regularly and reducing fast food spending, he was able to comfortably afford treatment.

Be upfront about financial concerns you have! Not everyone realizes that our mental health can impact our spending habits. The therapist may be able to help you; many therapists have sliding scales or reduced rate services or may be able to refer you to resources to help you pay for services.

And if you're looking for a podcast just like mine to help you get your finances on track, check out Money Girl. It's on the Quick and Dirty Tips network, and features short, actionable tips to help make money simple.

Another common question I received was related to waiting lists for services. This was closely related to the questions regarding cost. For instance, I’ve had several listeners and patients who want to use in-network insurance for services and found that in-network providers were full and had long waiting lists. When they looked at out-of-network care, they couldn’t afford the out-of-pocket expenses without help from insurance.

Group therapy can be a workaround for the cost and waiting list issue. Group therapy is often less expensive than individual therapy and is effective for many issues. You can find psychoeducational groups which focus on providing information about mental illness and coping strategies or more process-oriented groups that are centered on providing safe spaces for expression, validation, and feedback.

As a Dialectical Behavior Therapy expert, my practice routinely runs skills-training groups that can help manage all sorts of issues and diagnoses like depression, anxiety, PTSD, eating disorders, and Borderline Personality Disorder. These groups tend to be more psychoeducational. However, a grief or sexual assault survivors group may be more process-oriented depending on the format.

I love group therapy and recommend it all the time! It’s incredibly helpful to be in a space with others who share your experiences. You can learn from their stories and feel more empowered over time because you are able to help others in a similar position.

Another way to find affordable services is to work with an agency that engages in training. For instance, many times when you visit hospitals or other medical facilities, you are seeing a resident and not the attending physician. We have the same setup in mental health.

At my practice, there are trainees under my supervision who are providing low-cost services. One of the people on my admin team has a great way of talking to incoming patients about it. She says, “If you want to get a piece of Dr. Johnson, see one of her trainees, as she oversees the entire process!” There are many types of mental health facilities that have training programs—everything from private practice, community mental health, veteran affairs administration, and hospitals. Remember that these folks are being supervised, so you don’t have to worry about getting competent care.

You might think I’m awesome, but if it’s true it’s because I've had years of training and supervision to get me to this point. Believe it or not, culturally competent evidence-based therapists don’t make themselves! One of the ways I pay it forward is by providing training and supervision opportunities to others. Don’t hesitate to use this suggestion to your benefit.

What if my therapist is not a good fit for me?

Now, you might be thinking: "Dr. Johnson, I've been looking for a therapist, but how do I know if we're going to be a good fit?"

I get a lot of questions from folks who want a provider that matches their lived experience. I validate wanting to see yourself reflected in your therapist. The reason that this can become a barrier is because of larger systemic issues.

For instance, I’ve had folks who specifically want to see a Black psychologist because of a shared racial background. This totally makes sense! The problem? Only about 4% of psychologists are Black. When you add other variables, like being a gender or sexual minority, then that number gets even smaller.

Should you give up? Absolutely not! Remember that there are many competent therapists who have the training and put in the work! I spend time on growing both personally and professionally so I can work with those who are demographically or culturally similar to me and those who aren’t.

The key for you as the consumer is to make sure you are seeing the green flags that allow you to know this is likely a safe place. Read their websites and bios carefully. Don’t be afraid to ask if they have experience working with folks that have your background and/or mental health concerns. You can ask if they are anti-racist, anti-homophobic, etc. If they are truly an ally and engaging in proactive learning and self-reflection, it is likely that they will be able to help with your concerns. They also won’t mind if you find someone later on who does share some of your lived experiences and you want to make a switch. The goal here is to not delay taking your initial steps toward improved wellness.

Have you discovered any tips for navigating the healthcare system that you want to share? Let me know on Instagram @kindmindpsych. You can also reach out to me via my email at psychologist@quickanddirtytips.com, or leave a voicemail at (929) 256-2191‬.

All content here is for informational purposes only. This content does not replace the professional judgment of your own mental health provider. Please consult a licensed mental health professional for all individual questions and issues.

About the Author

Dr. Monica Johnson

Dr. Monica Johnson is a clinical psychologist and owner of Kind Mind Psychology, a private practice in NYC that specializes in evidenced based approaches to treating a wide range of mental health issues (e.g. depression, anxiety, trauma, and personality disorders). Additionally, she has a focus on working with marginalized groups of people including BIPOC, LGBTQ+, and alternative lifestyles to manage minority stress. She is also dedicated to contributing to her field professionally through speaking, training, supervision, and writing. She routinely speaks at conferences, provides training and workshops at organizations, supervises mental health trainees, and co-authored a book for professionals on addressing race-based stress in therapy.

Dr. Johnson earned her bachelor's degree from the University of South Carolina, completed her Psy.D. at the Arizona School of Professional Psychology, and completed her postdoctoral training year at Cherokee Health Systems in Knoxville, TN. She currently lives in Manhattan where she indulges in horror movies, sarcasm, and intentional introversion. You can find her on Instagram and online at kindmindpsych.com

Got a question that you'd like Dr. Johnson to answer on Savvy Psychologist? You can send her an email at psychologist@quickanddirtytips.com or leave a voicemail for the Savvy Psychologist listener line by calling (929) 256-2191‬.