In a recent article published on his website, Dr. David Susman PhD, a clinical psychologist and mental health advocate, addresses brilliantly the reasons why for the most part people with mental health issues do not seek treatment. This scenario is evermore exacerbated during the Pandemic. From his analysis, the average non-treatment rates for specific disorders were; schizophrenia (32%), bipolar disorder (50%), panic disorder (55%), major depression (56%), generalized anxiety disorder (57%), obsessive-compulsive disorder (59%) and alcohol dependence (78%). The question beckons; “Why does this happen? Why do people who need not get it?”
From the different angles one can try to analyze the reasons why, one that is undeniable is Stigma. The other possible one could very well be simple behavior patterns developed in a society where recommendations and guidelines are so politicized that they become not welcome to large segments of the population. As Dr. Susman puts it, if we all would follow the normal recommendations now commonplace in our way of life, (take vitamins, stop smoking, get regular exercise and eat healthy for instance), the prevalence of many chronic conditions including diabetes, hypertension, obesity and cancer would drastically be decreased. It is estimated that eliminating smoking would save an estimated 480,000 lives each year. Even though we were by law mandated to wear a seat belt when we drive, not to text and drive, not to smoke in public places and as a normal practice of hygiene to wash our hands and brush our teeth, and take those as common sense practices for not only ours but the overall common good, why is it that we still offer in some cases a stand of “ Don’t tell me what to do”, “You can’t make me do that”, “I’ll do whatever I darn well please”, and most recently regarding the wearing of protective masks or vaccination rhetoric “ do not restrict my freedom and constitutional rights”? Still, according to Dr. David Susman, such thoughts range from factual and real concerns to unrealistic or even irrational beliefs. Here are some of his suggested alternatives to think about how to work though different barriers and seek treatment:
- Fear and Shame – “I’mafraid to ask for help, embarrassed and ashamed to talk about the problem, scared of getting labeled as “crazy”, not wanting to find out if there is a real sickness” – consider that it is okay to feel that way. Know that 1 in 4 adults have some sort of mental illness. You are definitely not alone. While the negative Stigma surrounding mental illness is still undeniable and strong, more and more people are getting more comfortable about being open and asking for help.
- Lack of insight – “Nothing is wrong, people are getting worried for no reason. I am fine” – Maybe there is nothing wrong but if people who love you show concern, get a check-up. If nothing is wrong, you proved your point and gave peace of mind to those concerned aboutyou. If, however, the reason for concern is expressed by a professional at least listen and be open-minded to address the issue.
- Limited awareness – “Really things aren’t that bad, everyone has issues” – Even if you recognize you are struggling it is human nature sometimes to deny the symptoms or discard them as “not that serious” and trust they will pass. Don’t diagnose yourself, seek the opinion of a professional to determine what effective treatment options are available.
- Feelings of inadequacy – “I hate to admit my flaws or shortcomings, asking for help means I am a loser, I am able to cope better with things, I blame myself for my problems” – Would you see yourself as a loser or inadequate if you had cancer or diabetes? To ask for help and receiving it is not an indication you are an inferior person. You are not to blame for your current challenges.
- Distrust – “Hard to trust someone, I am afraid my personal information won’t be kept confidential, I don’t want people to find out I am in treatment” – Health care providers are trained and required to respect and honor your privacy, and confidentiality, and the information you provide cannot be released to anyone without your permission.
- Hopelessness – “Nothing will help me, I’ve tried treatments before and they didn’t work, I messed again it’s no use, my last treatment was horrible and made me feel worse, my therapist was incompetent, I will not go back” – Nowadays there are plenty of new medications and psychotherapy-treatments for mental illness available with solid evidence of effectiveness. If you had a bad experience in the past, try a different approach or a new provider.
- Unavailability – “There are no treatment programs or therapists near me, I don’t know how to find a therapist or treatment program” – To locate a competent professional or an appropriate mental health treatment can be a real problem. Look into your family medical providers, and local mental health organizations for help and information.
- Practical Barriers – “I don’t have transportation, I don’t have child care during my appointments, I can’t afford to pay for the treatments, I am too busy, I don’t have time for treatments” – Talk to your care providers, and even reach out to friends to remove these roadblocks. Explore public assistance or lower-cost treatment services to reduce financial burdens. Give thetime to get help absolute priority, it is just as important as anything else on your schedule.
Many more of these hidden factors such as fear, shame, inadequacy, limited awareness or hopelessness, are challenging, because mental conditions do not tend to show physical signs. Many people appearing to function well may be concealing a mental condition. When, and if, they begin to mention these issues, they can be encouraged to seek care for their distresses.
We have an ongoing battle to reduce and ultimately eradicate the Stigma and discriminations against such conditions, and send a clear message that these conversations need to be brought out into the opening from behind the curtains, where those struggling with mental health issues can feel free to talk about them and seek the help they need.
As Marcus Aurelius once said, “Sometimes living is an act of courage”
(Dr. David Susman PhD is a clinical psychologist, mental health advocate and a college professor. He holds a bachelor’s degree in Psychology from the University of Virginia, a master’s degree in Clinical Psychology from Marshall University and a Ph.D. in Clinical Psychology from the University of Kentucky.)
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