MENTAL HEALTH
CARERS ARAFMI
NSW INC.
Many people do not seek help when they first start to experience mental health symptoms;
it would be good to get people’s perspective on why this is;
The barriers that prevent a person from seeking help for mental health problems can be
numerous. Every individuals experience is different in discussing the reasons that individuals
refuse to seek help. The following listed possible barriers do not necessarily mean that these
are the sole reason for individuals not seeking help; it could be a combination, it may not be
listed here, or it may be a variation of a reason listed here. It is important to keep in mind that
every individuals experience with mental health is different to the next. Sometimes when
talking to a loved one about getting help for their mental health, they may become resistant or
defensive (to name a few reactions). This could stem from the barriers your loved one might
face in getting help.
Possible reasons for people not seeking help can range from a vast array of things. Reachout
lists some reasons as to why young people might not seek help, but these reasons can easily
apply to people of any age;
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Stigma and embarrassment about having a mental illness: stigma faced by themselves
and their families/carers. "Because you can't see it, it's not real. Unless I'm in physical
pain, there's no reason to go seek help." - ReachOut.com focus group participant
Problems recognising symptoms: when does it become a problem, when does it cross
the normal threshold of stress and anxiety? It is hard to pinpoint, and many people
believe that stress is a normal part of life
Self-reliance: young people wanting to deal with the problems themselves and rely on
the fact that they can fix it rather than turning to outside sources and support. Young
people commented on the fact that seeking outside support may look like a sign of
weakness, or that they are incapable of dealing with ‘normal real life’ problems
Trust: many young people thought that if they took their problems to an outside source
of support then it could lead to breaches of privacy and confidentiality, and that their
‘problems’ would be exposed
Hopelessness: it is suggested that the more hopeless the young person feels in their
distress and problems, the more likely it is that they won’t seek help. "I felt that no
person or helping service could help." – Reachout
In Bipolar Burble, a website by Natasha Tracy, consumers spoke themselves as to particular
reasons to why they did not seek help, including;
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The cost of medication
Medication side effects
Misdiagnosis/change of diagnosis depending on seeing different practitioners
Constant medication changes and medication side effects
Occasional hospitalisations
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MENTAL HEALTH
CARERS ARAFMI
NSW INC.
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Being undiagnosed e.g. during bipolar highs, people do not want to seek treatment when
everything appears good and well
Affordability such as lack of health insurance
Navigating a confusing system – who to call for help, put on hold, leave a message, you
have called the wrong person, we can’t help you anymore, and other similar sentiments
Too lazy to seek help and lack motivation to do so
The mental illness itself hindering the help seeking process e.g. if consumer has extreme
social phobia
Convinced that nothing or no one can help them because the mental illness is part of
them and so deeply ingrained
Belief that therapists are just there to hear you speak because they are paid to do so and
not because they actually care
Avoidance to deal with ‘self’ – whether it be not liking the person you were before the
illness and being scared what you will exist as once the symptoms have gone once
treated, or thinking others won’t like you so not seeking help because you are protecting
them from yourself
Disliking the way you are treated by mental health professionals, being treated as the
illness rather than who you are as a person – and losing your dignity in the process
Being labelled as paranoid or aggressive when trying to be assertive in your advocating
for yourself with your illness
Does not want to get help off someone if they have not gone through the experience of
mental illness themselves
Lack of education about mental illness: many people have not sought help at the time
they first started experiencing symptoms because it was a field that not many people
have knowledge of
Gender – males may feel like they are being weak and may be less likely to address the
situation
People are scared – mental illnesses can be scary for people, so they don’t want to deal
with it and rather stick their head in the sand, because if they don’t admit something is
wrong, then the problem isn’t really there. They may also be scared of what happens
when they do get help – see media portrayals of people with mental illness, or iconic
movies such as One Flew over the Cuckoo’s Nest
The person might be suffering from ‘anosognosia’, where it is evident that something
is wrong to many people but they themselves are not aware of it, or a form of ‘denial’
People may just feel overwhelmed about what is happening, and the person may not be
in the best place mentally – they might be afraid, feel alone, and like they are the only
one going through this – this leads to people hiding away and not accessing help, as it
is daunting on top of what they are already going through
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
W: www.arafmi.org
E: admin@arafmi.org
Information & Support Line
1800 655 198 – Free Call
MENTAL HEALTH
CARERS ARAFMI
NSW INC.
Other reasons for lack of seeking help could be;
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Previous experiences in trying to get help, or hearing horror stories of others trying to
get help but falling through the cracks or having a bad experience may turn other people
off getting help when they are first experiencing ill mental health (Tartakovsky)
People don’t have the time or the energy to deal with these things sometimes, especially
if they are busy at work all day – they simply do not want to talk about their problems
Money can be a factor in turning people off seeking help, believing that if they do it
could be quite costly. Many might prioritise other things if from a lower socioeconomic background, and put seeking help for mental health last after other more
necessary things that require money such as food, housing, etc.
Family and friends can also be a deterrent in itself, with the possibility of their kind
words being misconstrued e.g. “it’s okay, you will get through it”, or providing
solutions that are not very helpful, e.g. “maybe if you ate healthier, maybe if you quit
your job, maybe if you exercised more…..” etc. (Tartakovsky)
Lack of services and practicability: people from rural and remote regions may only have
a very small number of services that they can access, however even when able to access
them there is the added stigma of being in a small town and everybody knowing
everybody else and their business, and this is a big deterrent for people who live in these
areas. Practicability also comes into this in the fact that if people are from these areas
they may have to travel a distance which can also be costly and might not work for time
poor people or a range of families e.g. single parents. This also applies to CALD
individuals, especially if they are in rural and remote areas, the possibility that they can
find services that can meet their needs is slim in an area devoid of services (McPhee
2015)
Culture – in previous experiences in talking to people from different cultures about
mental health, it simply does not translate or the meaning gets lost in translation. In
some cultures there is the denial that mental health problems simply exist, and therefore
individuals do not get treated (Being representative, and TAFE classmates)
A study was conducted by Rickwood et al in 2005 revolving around the reasons as to why
young people did not seek help when experiencing mental health problems. Some of the
reasons young people experienced as barriers were;
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Negative experiences from seeking help in the past deterred people from seeking help
and also negative beliefs about seeking professional help (e.g. it would not be useful to
them) (Rickwood et al, p.g.16-17)
Embarrassment when talking about problems (Rickwood et al, p.g.17)
Feeling they can seek the appropriate help that they need from family and friends
instead of a professional, except if feeling suicidal thoughts they are less likely to
disclose to a parent due to fear and shame (Rickwood et al, p.g.17)
Lack of emotional competence – the inability to recognise or identify and describe
emotions, to understand emotions or the ability to manage emotions in an effective
manner (Rickwood et al, p.g. 13)
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
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Information & Support Line
1800 655 198 – Free Call
MENTAL HEALTH
CARERS ARAFMI
NSW INC.
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Media representations in movies of loopy psychiatrists (Rickwood et al, p.g.18) which
turns people off from going or knowing what to appropriately expect when they do seek
help.
Parents thinking help seeking was too expensive or not having mental health literacy
themselves (knowing where to seek help) (Rickwood et al, p.g.18)
Many people become defensive and resistant when asked about their mental health in
these circumstances; it would be good to shed light on the (usually very understandable)
reasons for this too, (as carers can become frustrated and push too hard for treatment
which is usually bad for the relationship and can actually stop people seeking help);
People become defensive and resistant when confronted by loved ones when they may have a
mental health problem due to a number of factors, including fear, embarrassment, shame,
vulnerability, and denial to name a few. Some people might feel they are being picked on when
a loved one confronts them about seeking help, or that they are being criticised. Some people
who might have a mental illness may not be able to acknowledge it or understand that they are
sick – this is called anosognosia. This can be diagnosed in as high as 50% of people with bipolar
and schizophrenia. Other people might not seek help due to feeling they were being judged, or
completely terrified due to past experiences of events involving mental illness and other people
(Bernstein 2010). Bernstein reports from the Wall Street Journal that tough love and
interventions are rarely the way to address such situations, and rather you should avoid a debate
and find common ground with your loved one. Experts say that there are ways to help out a
loved one who may become resistant to receiving help. These include being gentle with them,
sharing your own vulnerability, avoiding a debate and asking questions instead, focusing on
the problems that your loved one can see, suggesting that they see a GP rather than a specialist
right off the bat, work as a team by going to appointments with your loved one, ask for help
yourself if you need it, and enlisting the help of other family and friends who might notice
behaviour and might be able to facilitate a breakthrough. Lastly, clinical psychologist Xavier
Amador says that sometimes they may not get help based on the strength of your argument, but
they might if you ask them to get help for your sake.
There then comes a time when a person might be motivated to start to address their
mental health and again, it would be good to get some consumer perspectives on what
helped this change of heart.
When people become motivated to start to get help for their mental health, there are a range of
factors which contribute to this. Consumers noted on the Healthy Place Mental Health Channel
that they sought help when:
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They were finally faced with a confronting decision, such as getting help because if
they didn’t they will lose their job, their partner, or their family
They needed to be a better parent for their children, which was not happening when
they were in bed all weekend with depression
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
W: www.arafmi.org
E: admin@arafmi.org
Information & Support Line
1800 655 198 – Free Call
MENTAL HEALTH
CARERS ARAFMI
NSW INC.
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Afraid they their marriage would be destroyed due to symptoms of a mental illness (e.g.
Bipolar)
Being referred to a better person (such as a psychiatrist or counsellor) after previous
practitioners in earlier years had not diagnosed them correctly or wanted to put them on
medication which they did not want
Partners had left them, so they felt inclined to get help
They did not know anything was wrong with them, until a friend noticed that they were
experiencing similar symptoms to themselves and so referred them onto their
counsellor/psychiatrist
Break down of relationships
Some factors for young people becoming motivated to seek help were;
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When people had positive experiences in the past seeking help for mental health, they
were more likely to seek help in the future, whether the experience was their own or a
story of a positive experience from someone they knew (Rickwood et al, p.g.18)
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Males who have sought help for problems have shown to do so through the influence
of others (Rickwood et al, p.g.20)
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Having a higher level of emotional competence (Rickwood et al, p.g.18)
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Knowledge about mental health such as symptoms and where to seek help when they
needed it (Rickwood et al, p.g.18)
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Having social influences to obtain help such as friends, family, and members of the
community. For example, a classroom outreach program was developed where GPs
spoke to students to engage with them about mental health and break down barriers. An
evaluation found that this program had increased students attitudes in wanting to seek
help when in distress, and had decreased the barriers for young people engaging with
GPs (Rickwood et al, p.g.19)
These are only some of the reasons why some people may finally seek help for a mental health
problem, but they may differ for every individual or the reason why someone may seek help
may not even be listed here. It is individual to each person and their journey, and this is
important to keep in mind that this list is not a conclusive list of reasons or answers for barriers
or motivation to seek help.
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
W: www.arafmi.org
E: admin@arafmi.org
Information & Support Line
1800 655 198 – Free Call
MENTAL HEALTH
CARERS ARAFMI
NSW INC.
References
Bernstein E, 2010, A way out of depression, The Wall Street Journal,
<http://www.wsj.com/articles/SB10001424052748703946504575470040863778372>
Breaking
down
barriers
to
help
seeking,
<http://au.professionals.reachout.com/breaking-down-barriers-to-help-seeking>
Reachout,
McPhee E, 2015, Reasons why people suffering from mental illnesses do not get help,
Monsenso,
<http://www.monsenso.com/tag/why-dont-people-get-help-for-mental-illnesses/>
Rickwood D, Deane, F. P, Wilson, C. J, Ciarrochi, J. V, 2005, Young people's help-seeking for
mental health problems, Australian e-Journal for the Advancement of Mental Health, 4 (3), 134.
<http://ro.uow.edu.au/cgi/viewcontent.cgi?article=3159&context=hbspapers>
Tartakovsky M, What prevents people from seeking mental health treatment?, Psych Central
<http://psychcentral.com/blog/archives/2013/01/14/what-prevents-people-from-seekingmental-health-treatment/>
Tracy N, 2012, What made you seek help for your mental illness?, Healthy Place,
<http://www.healthyplace.com/blogs/breakingbipolar/2012/09/what-made-seek-mentalillness/>
Why don’t people get help for mental illness?, 2012, Bipolar Burble,
< http://natashatracy.com/mental-illness-issues/dont-people-get-help-mental-illness/>
State Office Address:
Suite 501, Level 5, 80 William St
Woolloomooloo, NSW, 2011
ABN: 70 653 824 650
P: (02) 9332 0777
W: www.arafmi.org
E: admin@arafmi.org
Information & Support Line
1800 655 198 – Free Call