Why Might Someone Avoid Getting Help For A Mental Health Concern?
When we think of avoidance what often comes to mind is the pleasure-pain principle, which is a psychological concept suggesting that human behavior is driven by the desire to seek pleasure and avoid pain. While this can be overly simplistic, it is a real reason some people avoid getting help for their mental health concerns, as it is often more emotionally painful to confront a mental health issue than to avoid it, at least in the short term. Below is a list of some of the other common reasons people might avoid getting help for a mental health concern.
Discomfort
There is an adage in the mental health field that most people will not seek help until the discomfort of staying the same becomes greater than the discomfort of changing. We often hear about people needing to “hit rock bottom” before they are willing to make necessary changes in their lives, and this discomfort is the reason why. Unfortunately, mental health problems that are not addressed while they are minor often leads to symptoms escalating in severity, causing greater impairment in functioning or even a crisis situation that can be life-threatening. I am hopeful that as a society we are starting to shift perceptions of mental health care as being reactive to something that should be proactive, which is what the field of preventive medicine advocates for.
Lack of Awareness
Let’s face it, we are often unaware or blissfully ignorant of our own challenges and shortcomings, which in some cases can be a form of identity protection or self-preservation. However when this prevents us from seeing ourselves accurately or from having necessary insight into our own lives, this can negatively impact our wellbeing and self-efficacy. For some people this might mean not recognizing that they are experiencing a mental health issue, whereas for others who do have this awareness, it might look like minimizing or dismissing their symptoms as insignificant or assuming they will resolve on their own, thus preventing them from seeking help.
Stigma
One of the most pervasive causes of someone avoiding getting help for a mental health concern is stigma, which can be divided into social stigma and self-stigma. Social stigma is when we are—or have a fear of being—judged, labeled, or discriminated against by others, whereas self-stigma is when we judge or shame ourselves. Self-stigma often results from internalizing others’ negative beliefs or messaging, leading to perceptions of ourselves as “weak” or as “moral failures.” While we have made great strides as a society in reducing mental health stigma, at least in the Western world, we have by no means overcome it, especially in certain communities, cultures or religions. This is why one of my aims as a mental health professional is to educate and normalize mental health as being a part of overall health, and to reframe the view of seeking help as a weakness to a strength.
Cultural or Religious Beliefs
Cultural attitudes toward mental health can differ widely across the world as well as within countries and smaller communities, or even between genders. For example, it is not uncommon for some countries or cultures to view mental illness as a sign of personal weakness or family shame, where value is placed on “saving face” or where symptoms might be expressed somatically rather than emotionally due to this being more socially acceptable. In certain religions, mental illness may be seen as spiritual punishment or possession that can only be resolved through traditional healers or religious leaders or that warrant rejection or exclusion from the group.
Fear and Mistrust
Connecting back to the theme of avoidance is the fear that one will receive a certain diagnosis or be prescribed medication, which might threaten one’s self-perception or entail negative side effects and therefore can prevent people from getting necessary help. Past negative experiences with mental health providers or systemic discrimination or abuse can erode trust in the profession or mental healthcare system, particularly among marginalized groups. Furthermore, people might worry that their sensitive information will be leaked or shared with others, even though there are strict privacy and confidentiality laws in place that prohibit this.
Accessibility
Another common barrier to people seeking mental health care is accessibility, whether it be logistical restrictions or financial constraints. In rural or smaller communities for example, there may be provider shortages, long wait times, or limited services offered that may not meet a more diverse range of mental health needs. Additionally, people may not be able to make in person appointments due to mobility or transportation limitations or do not have adequate technological knowledge or devices for virtual sessions, which is not uncommon in elderly or low income populations. Lastly, mental health services can be financially prohibitive to many, especially if they do not have insurance or among providers who do not accept insurance.
Mental Health Conditions Themselves
Certain mental health conditions often have symptoms that in and of themselves make it difficult for people to seek help, or to remain engaged in their mental health treatment even if they are motivated to do so. For example, depression often includes symptoms of low energy or psychomotor slowness that makes it too physically arduous to reach out for help. ADHD can impair executive functioning, or the ability to plan, organize, and remember appointments or follow through with treatment recommendations or medication compliance. And anxiety can be paralyzing or lead to avoidance, which is commonly known as the fight/flight/freeze/fawn response as seen in extreme cases or in PTSD.
Conclusion
As we can see, there are myriad reasons why someone might avoid getting help for a mental health concern. Mental health is complex and it is important to have empathy and compassion for yourself and others who may be avoiding getting mental health help. If you or someone you know needs help, feel free to schedule a complimentary phone consultation so that I can assist you in finding the right type of support.