Barriers to Mental Health Help-Seeking
It may be difficult for a caregiver to follow through on referrals for mental health. Visit the Curriculum -> Mental Health section for more information. Sometimes, caregivers can’t get to their appointments because of practical issues, like child care or transportation. Other times, cultural attitudes and beliefs about mental health and treatment may influence whether a caregiver asks for help. Consider the following ways that culture might be a barrier to seeking treatment.
We include the following examples to help you think about POSSIBLE barriers your families face. These are based on research and home visitors’ experiences, but not everyone from a certain group will have the same experience.
- Money/healthcare coverage for services
- About 2-3 times more Black and Latino/a individuals live in poverty than White individuals
- Lack of insurance is a major barrier to receiving mental health services for some minority groups. According to a 2011 U.S. Census Bureau report, 86% of White women, 79% of Asian women, 77% of Black women, 70% of Native American women, and 63% of Latina women were insured. White Americans are more likely to use mental health services than other ethnic groups. But, if you only consider individuals with insurance, ethnic differences in service use are much smaller.
- Child care and transportation
- Limited social support and/or money may make it difficult for caregivers to find child care or transportation to make it to their appointments.
- Difficulty handling appointment & waitlist
- Workers whose schedules change weekly may have trouble scheduling appointments in advance
- Language barriers
- Language barriers can lead a counselor to misunderstand a caregiver’s concerns.
- The caregiver may feel uncomfortable expressing intimate feelings for fear of being misunderstood by a counselor who doesn’t speak their language.
- In 2006, only 20% of mental health providers offered interpreter services.
Beliefs as Barriers
- Past experience
- Most counselors are not from minority groups, so a cultural/ethnic mismatch between counselor and client often occurs. A poor match can lead someone to quit therapy early and believe it does not work.
- More Black and Latino/a individuals report feeling disrespected or looked down upon by their provider than White individuals
- Historically, Black individuals have been misdiagnosed more often than White individuals.
- Many immigrants come from communities with little experience with mental health counseling and therefore may not understand its potential value.
- Family or personal attitudes
- Different cultural groups hold different values regarding mental health and how to address it. It is important to talk with the caregiver regarding how they feel about this sensitive topic. This may include having conversations about family values, experiences of people in their lives who have lived with mental illness, or other life events and cultural beliefs that shape personal attitudes toward mental health and help-seeking.
- Many Americans believe that depression reflects personal weakness. This perspective is even more common among Black individuals.
- Fewer Black and Latino/a individuals find medication acceptable than White individuals.
- Privacy and stigma
- Different cultural groups value privacy in different ways. Some may believe that mental health challenges should not be discussed openly, and therapy may therefore not be a commonly used option. Stigma associated with mental health help-seeking is common in many cultures but stronger in some groups. In your conversations with caregivers, it is important to acknowledge these beliefs.
- In some cultures, individuals will not open up to one another unless a personal relationship has been developed. For these individuals, a professional identity as a “therapist” or “counselor” holds little value by itself for building trust and rapport.