Why do people avoid mental health treatment?

According to the National Institute of Mental Health (NIMH), one in five U.S. adults is living with a mental illness right now. Yet, a large portion of this group never seeks help. Why?

This statistic accounts in part for those who lack access to mental health services—but this doesn’t provide a comprehensive explanation, especially considering that more Americans have access to mental health services today than they have in the past. As it turns out, many people avoid or forego mental health treatment for several reasons, many of which are tied to stigma around mental health.

How Frequently Do People With Mental Health Issues Seek Treatment?

According to research from NIMH, about 50% of people with a mental health condition do not seek treatment. Of those who do, women are more likely than men to look for mental health treatment.

However, this statistic is slightly misleading, according to Diana M. Missig, founder of Racing for Mental Health, a nonprofit designed to promote mental health awareness and destigmatization. “This only refers to those diagnosed with a condition, not the hundreds of thousands undiagnosed,” she says. “Others might seek treatment but stop because the treatment is not working.”

This means that the gap between people with a mental health condition and those who actually get treated might be even wider than it appears. But these conditions rarely resolve themselves; to truly manage and mitigate symptoms in the long term, treatment is the most effective course of action.

What’s Stopping People from Being Treated?

Stigma is consistently one of the most common roadblocks to treatment for mental health conditions. However, this term covers an array of emotional and mental contributors. There are many smaller, more insidious emotions that develop as a result of stigma, as well as other strong inhibitors that can prevent someone from seeking help or sticking the therapy process out. These include:

1. Judgment

Being judged by others—more specifically, being seen as weak—is a huge roadblock for those who need mental health treatment, says Lindsay Raffaele, IIN Certified Holistic Health and Nutrition Coach. 

“I think that in this day and age, our society is so focused on bigger, better, faster, stronger, that unfortunately something like seeking help for mental health issues can be perceived as being weak,” she explains. “I say ‘perceived’ because typically, this is the story that we tell ourselves; it’s not fact or even necessarily real. Once we create space for a more positive mindset, we see a lot of their other concerns fall into place. At the end of the day, seeking help for mental health issues, or any health issue for that matter, should never be seen as weak—it’s actually quite the opposite. It’s a proactive measure to a better life.”

It can be incredibly hard to talk about your struggles and be honest and open. Despite the narrative of seeking help being a sign of weakness, doing the work to better yourself and your mind is one of the bravest, smartest things you can do.

2. Doubt

Another obstacle that prevents people from seeking mental health care is their doubt that it will work. “Unfortunately, some people have had negative experiences with the mental health care system in that they (or someone they knew) attempted treatment with providers who were either not familiar with or not using the appropriate evidence-based treatment for that particular disorder,” says Ashley Smith, PhD, a Licensed Psychologist. “If all you have heard is that therapy doesn’t work, why would you give it a shot?”

It may take a couple of tries to find the right provider, but it also helps to do your research beforehand—look for clinicians who specialize in your issues, and be willing to speak to multiple providers before you make your choice.

3. Pride

Sometimes pride poses an interesting challenge as well, in that people have a hard time admitting they need help and surrendering to the treatment process. “Sometimes people think that they should be able to solve their problems without any input from a professional,” says Lisa Larsen, PsyD, a licensed psychologist. 

“There’s a stigma against mental illness, and many people don’t want to be considered mentally ill, even though, if they’re suffering, the therapy could make them less mentally ill,” Larsen says. “Other people fear that resurfacing events from the past will be painful and upsetting, which is sometimes true. Again, however, it seems more logical and healthy to address the past events so they don’t keep having a negative influence on their lives, rather than continue to repress or deny the events.”

4. Fear

Another primary reason people avoid therapy is the fear they harbor: “Fear of change, fear of the unknown, fear that they may outgrow their friends, family, and loved ones,” explains therapist Sarah Thacker. 

“People also seem to be very afraid of feeling their feelings and of being judged. Vulnerability is hard, and therapy by nature requires being open, honest, and vulnerable, which does not come naturally for so many,” Thacker says. “Once people find therapy to be an accepting, safe place where they can open up at their own pace, they find it to be the best thing that they’ve ever experienced. They feel as though the growth, comfort, and ease that therapy can create opens them up to truly being their best self.”

Others might be afraid that opening themselves up to their emotions and re-examining past events will be painful and upsetting—which may be true. Even so, this pain will persist until it gets treated. It might be easiest to see therapy as getting stitches for your emotions—it might hurt a little more in the moment, but it is the only way to truly heal these wounds. Eventually, the pain will go away, rather than fester and continue to cause pain. 

5. Misinformation

People also forego mental health treatment because they’re misinformed about what it involves and how they’ll be perceived by their therapist. “Having been a therapist for several years, I have come across many individuals who are hesitant to engage in treatment. More often than not, people are misinformed about what therapy actually is,” says Robyn Gold, Licensed Clinical Social Worker.

“Many individuals have developed the belief that if they attend therapy, it means they’re crazy, which simply isn’t true. I think this perspective is likely a result of how the media portrays mental health professionals,” Gold says.

“Crazy” is an overused and charged term that doesn’t accurately represent mental health issues or getting help for them—simply having a mental health condition in no way means that someone has lost their mind, and neither does seeing a mental health professional. Rather, getting treated for mental health issues is one of the wisest things you can do. It’s a sign of forethought, humility, and wanting to better yourself.

6. Impatience

Some people might give therapy a try but then stop before they can make any real progress. “Many people will meet with a therapist once or twice and then stop altogether, for a myriad of reasons,” says Emily Simonian, Licensed Marriage and Family Therapist (LMFT) and Head of Learning at Thriveworks. 

“Typically, that happens when they find dealing with emotions to be too difficult, they feel there should’ve been ‘results’ right away, or maybe the therapist wasn’t a fit and they just give up,” she says. “The truth is that therapeutic change takes time (anywhere from eight to 12 sessions on average) and choosing the right therapist for yourself is important, so you may have to try a few different providers before finding the right match.”

Messig also highlights the importance of giving the therapeutic relationship time to develop: “The relationship between the therapist and the client is crucial to the success of the treatment.” Don’t rush the therapy process—take the time you need to find the right provider for you and let progress happen.

How Can Going to Therapy Benefit Me?

Therapy is proven to be incredibly beneficial for people with a variety of mental health concerns, even those who don’t have a specific issue or condition.

According to Missig, seeking treatment for a mental health condition has many benefits, including improving quality of life, improving well-being, learning coping skills, lessening the intensity of triggers, and improved self-esteem, among others.

Missig also points out how what’s learned in therapy can help clients maintain their progress in the long term. “Treatment of mental health conditions can teach someone what triggers are, [teach them] how to avoid or cope with them, and help a person develop strategies to manage challenges in life,” she says. “This can prevent worsening mental health issues and can assist in developing good decision making and problem-solving skills.” 

Most people who seek help “feel better about themselves and their lives,” Missig says. In fact, research shows that 75% of people who seek treatment for their mental health see improvement in symptoms and/or quality of life within six months.

Whatever you’re struggling with, it’s worth reaching out to a mental health professional about your symptoms. They can work with you to create a comprehensive treatment plan, suggest possible medication options, or even direct you to someone more qualified who specializes in your unique needs.