Barriers to Receiving help for mental healthcare

Abstract

Mental healthcare has many barriers which prevent a simple solution to a person needing counseling.  Four of these major barriers are stigmas, misconceptions, accessibility of care, and costs.  Two of these barriers are internal.  The first internal barrier is the stigma can lead a person to be shamed and silenced in admitting their need for counseling due to the negative stereotypes that have been promoted through the years.  The second internal barrier is misconceptions about mental healthcare professionals and patients are still prevalent in many circles.  There are two external barriers.  The first external barrier is accessibility to services are limited and the second external barrier is the  cost for some people are too great as many insurance companies will not provide coverage for mental healthcare as they see the patient as a risk to their profit margins.

Barriers to Receiving help for mental healthcare

There are no simple answers for the barriers confronting those needing to receive mental healthcare.  There are several barriers to receiving help for mental healthcare which blend together to create a tsunami of conditions which create barriers to receiving proper mental healthcare. Two internal issues that most who suffer have to overcome is the perceived stigma attached to mental healthcare and misconceptions concerning the nature of mental healthcare (Hunterdon County, 2008).  Further complicating the situation are the two factors of accessibility of mental healthcare services and the cost of these services (Hurd, 2001).  These four factors combine to work as barriers for people to seek proper mental healthcare.  This is especially true for children and adolescents (Levesque and Schachter, 2006). Despite an increased awareness of the need for mental healthcare for individuals, many people still have a negative image of the care and people who require it.  There seems to be a perception of insanity or radical mental instability for anyone who seeks such care (British Medical Association, 2008).  Local governments are now becoming involved to help educate people to the nature of mental healthcare with promotion by these governments to adopt mental health plans for citizens.  Even the President of the United States has addressed the necessity of such programs to educate the general public (Hunterdon County, 2008).  Another barrier is the accessibility to needed care.  Since the 1950’s, there has been a decrease in the number of psychiatric hospitals which means fewer beds to treat cases (Hurd, 2001).  This decrease in psychiatric hospitals has also meant that many patients would be denied treatment because of transportation difficulties in reaching the few remaining hospitals which for the most part are located in larger metropolitan areas of the country.  Accessibility becomes difficult for younger patients because of the operating hours for the facilities would interfere with school (Levesque and Schachter, 2006).  Finally, the financial burden for mental healthcare is too much for many families who lack the resources to pursue treatments for loved ones.  Each of these barriers must be considered in full detail to fully understand the problem.

Stigma

The stigma attached to mental healthcare leads discrimination towards patients.  This stigma leads to limited or missed opportunities for treatment.  Even the media prorogates this stigma as in a recent study, 40% of British tabloids described those needed mental healthcare as “loony” or “nutter” (British Medical Association, 2008). Hollywood does not help the stigma with such characters as Norman Bates and Michael Myers in popular movies. Studies have indicated that as many as one in five Canadian students are in need of some type of mental healthcare but will not seek it due to peer pressure that would see the child as being “different”.  This feeling of being “different” leads to an individual’s shame and silence which further builds a barrier to receiving help. (Levesque and Schachter, 2006).  Hunterdon County, New Jersey pointed to the need for public education about mental healthcare for students and parents to overcome the stigma attached to such care from an earlier time. Due to the stigma, a community may isolate an individual who has mental healthcare issues (Hunterdon County, 2008). There is a growing need to remove this barrier as one in twelve United States teens between the ages of 12-17 are experiencing or have experienced a major depressive episode in the past year (Grohol, 2008).  This study has also shown that young girls are prone to depression as opposed to young boys.  Intervention not hindered by the perceived stigma is necessary to insure early treatment.

Misconceptions

There is a misconception in some areas that mental healthcare is harmful to the individual though there is no evidence to support such an assumption.  For instance, a research study in 2000 created quite a controversy in stating that as much as 38% of people who underwent grief

counseling was negatively impacted by the experience.  However, recent research has indicated

quite the contrary.  In fact, the original study was shown to be very flawed (Willenz, 2007).

The British Medical Association (BMA) has pointed out recently that there was a misconception about mental healthcare in which those who sought such care were suffering from “madness” (BMA, 2008).  This misconception leads to unwillingness among students and parents to seek needed help. These misconceptions lead to people having to build up the courage to seek aid.  These misconceptions also bleed over in views of mental healthcare professionals which make people less likely to seek the help they need (BMA, 2008).

Accessibility

Accessibility of mental healthcare resources has become another major barrier for receiving help.  A major problem in accessibility is the lack of knowledge concerning available resources to patients both in the private and public sectors.  Primary healthcare givers are not educated about potential mental healthcare available to their patients.  There is a severe lack of communication between professionals concerning treatments and medications (Hunterdon County, 2008).  While some local governments are trying to implement mental healthcare plans for their citizens, at the state level there has been a steady decrease in mental healthcare with the reduction of state operated facilities (Hurd, 2001).  This creates a situation where the members of a lower socio-economical class do not have access to mental healthcare.  Also, with the closing of these institutions, the remaining hospitals are left in metropolitan areas and bring hardship to those in rural areas who need care.

Cost

The cost of mental healthcare is a major barrier for many people.  Despite the fact that there are now many wonderful treatments for various conditions, insurance companies will not offer mental healthcare coverage (Brar, 2007).  Health insurance companies have a tendency to see mental healthcare patients as being unprofitable in the long term.  Also, there are difficulties concerning the personalized treatment needed for each patient which makes standardized payouts problematic.  Efforts to regulate on the Federal level have not been successful but there has been some success in regulations on the state and local levels but this still does not solve the problem of accessibility (Brar, 2007).

Conclusion

Multicausality is the concept that there are no simple solutions.  It further states that the cause of a problem cannot be established with certainty because of the combination of barriers which the individual faces internally and externally in seeking mental healthcare (Mandrell and Schram, 2006).  The first internal barrier is that of the stigma which is attached to mental healthcare.  A person must build up the courage to seek help (BMA, 2008).  The second internal barrier is overcoming misconceptions about mental healthcare and the professionals who are in this field.  The first external barrier is overcoming the accessibility problem.  The second external barrier is the cost issue which is massive.  Insurance companies still lag in their coverage of mental healthcare due to misconceptions and stigma about mental healthcare.  These barriers are massive but can be overcome.

References

Hunterdon County Mental Health Care Board. (2008). Hunterdon County Mental Health Plan

2008 – 2013. Retrieved May 27, 2008 from http://www.co.hunterdon.nj.us/depts/humansv/MentalHealth/MentalHealthPlan.pdf

Levesque, Peter & Schachter, Howard. (2006, September).  Voices for Children, Sticks and Stones: Breaking the stigma of child and youth mental health difficulties through our schools.
Retrieved May 27, 2008 fromhttp://www.voicesforchildren.ca/report-Sept2006-1.htm

British Medical Association. (2006, June). Child and adolescent mental health – a guide for healthcare professionals. Retrieved May 27, 2008from http://www.bma.org.uk/ap.nsf/Content/Childadolescentmentalhealth~Barriers

Hurd, Sharra. (2001, September). Barriers to Treatment for Individuals with Schizophrenia and Manic Depression. Paradigm Magazine, Vol. 5, No.2

Retrieved May 27, 2008 from http://www.treatmentadvocacycenter.org/GeneralResources/article47.htm

1 in 12 U.S. Teens May Suffer from Depression

Grohol, John M. (2008, May 13). 1 in 12 U. S. Teens May Suffer From Depression. APA Press Release. Retrieved May 27, 2008 from
http://psychcentral.com/news/2008/05/13/1-in-12-us-teens-may-suffer-from-depression/2284.html

Willenz, Pam. (2007, July 29). NEGATIVE VIEWS OF GRIEF COUNSELING ARE NOT SUBSTANTIATED BY THE RESEARCH, EXPERTS SAY. Retrieved May 27, 2008 from http://www.apa.org/releases/grief_counseling.html

Brar, Sadajyot. (2007, February 15) Lack of insurance coverage prevents mental health care.

The John Hopkins Newsletter. Retrieved May 27, 2008 from http://media.www.jhunewsletter.com/media/storage/paper932/news/2007/02/15/Science/Lack-Of.Insurance.Coverage.Prevents.Mental.Health.Care-2725116.shtml

Betty Reid Mandrell & Barbara Schram, (2006). An Introduction to Human Services: Policy and Practices. (6^th edition) Boston: Pearson Education, Inc.