More than one in four Americans deal with a mental health disorder in any given year, according to data compiled by Johns Hopkins University. Women are more likely to suffer from major clinical depression, but men are four times as likely to commit suicide. Mental health struggles are experienced by every gender, race, sexual orientation, or social class, so no one is immune to it.
But while we know mental health is a significant problem in America, getting people the right treatment is often easier said than done. Here are three reasons why people don’t get the right mental health help.
Lack of access
In 2016, one study projected that the behavioral health field would have 250,000 fewer workers than needed by the year 2025. Not surprisingly, the numbers are worse in rural areas, as more than half of all counties in the United States have zero psychiatrists. A person in Northern Virginia can go look for therapists in Washington DC, but a person in rural downstate Virginia simply won’t have as many options.
Even in bigger cities, the wait for mental health care can be frustratingly long. There may be psychiatrists and other mental health professionals working in your town, but that doesn’t mean they’re accepting new patients. It’s common for mental health workers to have a high caseload, which means you’ll face a waiting period of weeks or even months. For someone who is severely depressed, that wait could make them feel more helpless than ever.
Some states are actively trying to recruit more medical students interested in psychiatry. They’re also trying to place those students in rural areas for training. The emerging field of telepsychiatry may also allow doctors to serve patients without being in the same room as them.
Health insurance issues
In the United States, it’s hard to find treatment for conditions like depression, anxiety, and bipolar disorder. It becomes nearly impossible if you don’t have health insurance. While Medicaid is currently the biggest payer for behavioral health services in America, not every medical or psychotherapy office will accept new patients on Medicaid. Reimbursement rates for Medicaid aren’t as robust as they are for private insurance. As a result, 53 percent of uninsured people with a mental health disorder reported not receiving treatment in one survey.
The more severe the mental health issue, the less likely you’ll be able to function in day-to-day life without some kind of treatment. In Los Angeles County, experts estimate that 30 percent of all homeless people suffer from severe mental health problems. Nationwide, the percentage is believed to be 13 to 15 percent, but the Southern California area has more single adults who live on the streets long-term.
Stigma
Experts say the stigma of seeking mental health care has decreased significantly in recent years. That’s promising, but there are still people who are afraid of discussing issues like depression and anxiety. The World Health Organization says that women are more likely to discuss mental health symptoms with their primary care doctor, while men are more likely to use inpatient care. Women are often stereotyped as “more emotional,” which to some people means they’re more likely to have mental health issues.
Those stereotypes hurt both men and women. For instance, a woman might not reveal her symptoms for fear of being called “hysterical,” while a man might not disclose his symptoms for fear of being called weak. On a logistical level, overcoming stigma is easier than overcoming a lack of access or lack of health insurance, but it does require someone to face their fears or worries of being judged and seek out help from qualified medical or psychological professionals. Once they reach out, many patients report a sense of relief.