Conversations about mental health are more open than ever. With growing access to mental health services, a cultural push toward emotional well-being, and younger generations leading the charge, we’ve made huge progress in normalizing therapy.
Still, many people across all ages and backgrounds who could benefit from mental health treatment choose not to pursue it. Whether because of stigma, fear, or logistical hurdles, they remain on the sidelines.
So why do people not go to therapy?
Understanding why people hesitate to seek mental health treatment is the first step to moving past the concerns. Here are 20 of the most common reasons people avoid therapy, along with ways to reframe, support, and open the door to healing.
1. The Impact of Stigma
Stigma remains one of the most common barriers to therapy. People fear being labeled as “unstable” or “broken,” when in fact, seeking support is a powerful act of self-care.
For care providers, the goal is to normalize seeking help by highlighting the fact that mental health is health.
2. “My Problems Aren’t Serious Enough”
Many people incorrectly assume that mental health issues must be dire before it is appropriate to seek mental health care.
But therapy can support everything from relationship issues to low self-esteem. There’s no threshold of suffering required to seek help.
3. “It’s Too Expensive”
The cost of mental health care can be daunting, but it’s often more accessible than people realize.
Patients may be unaware of insurance options and payment plans. They also might not see mental health support as a worthy investment given how society tends to devalue mental health wellness.
4. “I’m Too Busy”
Therapy-avoidant people can use a busy schedule as an excuse for failing to engage with a therapist. A packed calendar can feel like a valid reason to delay therapy but untreated stress, anxiety, or burnout often make everything harder. Virtual appointments, flexible hours, and short-term therapy models can fit into even the busiest schedule.
5. “I’d Rather Talk to My Friends”
Social support plays a major role in promoting wellness of all sorts. But talking with friends and family might not be enough when a mental health issue has escalated. Most friends, of course, are not trained to deal with psychiatric disorders. Their advice might be unproductive or even dangerous. Relying on friends also does not offer the consistency and intensity of a therapeutic process.
6. “I Don’t Want a Therapist to Judge Me”
Some clients worry that a therapist will judge them poorly for past actions and current thoughts. People who have been traumatized and/or abused can be too ashamed to relay their experiences. Therapists often do well to anticipate these reactions by discussing them with clients at the outset of therapy.
7. Belief That Medication Is Enough
Medication can be helpful, but it’s rarely a complete solution. Research shows that combining therapy with medication often leads to better outcomes, especially for people dealing with anxiety, depression, or other mental health conditions.
8.“I Don’t Want to Talk About That”
Some people stay clear of therapy out of concern that they will immediately have to talk about topics they feel are taboo. They might feel especially uncomfortable talking about abuse, trauma, or other personal issues. Therapists can identify and address these fears at the outset, in part by making it clear that the clients can inch their way toward the sensitive topics at their own pace.
9. Fear of Betraying Loved Ones
Talking about family, partners, or past trauma may feel disloyal. A wife may feel she would be betraying her husband if she divulged details about his infidelities and their impact on the marriage. An adult child of an abusive parent might see airing the family’s dirty laundry to a therapist as an indictment of important relationships. Therapy isn’t about assigning blame. It’s about processing experiences and building a healthier future.
10. “I Don’t Need Help”
Denial can be a powerful force. People may not realize how their mental health is affecting their life or may assume that their symptoms are just a normal part of the human experience.
11. Worry That Others Will Feel Justified in Labeling Them
In some cases, a person is reluctant to seek help because they have been told for years that they were “too emotional” or “a mess.” In their mind, seeking therapy might feel like confirming those labels. But therapy helps people reject harmful narratives and reclaim their mental health on their own terms.
12. Believing They Deserve to Feel Bad
Even when people know that they need mental health support, they can feel too ashamed or belittled to believe they deserve a good life. A person may even think that they’ve done something to deserve the pain they feel. In a way, they think that they are not good enough to justify the time and expense of therapy.
13. “Getting Help Is Too Complicated”
Avoiding seeing a therapist sometimes comes down to resources and logistics.
For some, the lack of transportation makes it impossible to book appointments. Others are not sure how to find therapists who can work with them. Additionally, language and cultural barriers can cause people to go without the help they need because they do not know where to get it.
In these cases, outreach from therapists is important — everything from telehealth appointments to bilingual services within a therapy practice. In many cases, advertising these flexible resources can help a practice attract new clients.
14. “I Am Not Depressed, So I am Fine”
Some people think that therapy is only for people who are feeling down. They assume that their anxiety, compulsive behaviors, or relationship issues cannot be helped by therapy because they do not have the classic signs of depression.
Reframing therapy as a tool for growth, and not just a crisis intervention, can make it feel more relevant.
15. Anxiety About Starting Therapy
The fear of trying something new can hold many people back from seeking help, especially those who are anxious by nature. Therapy may seem like an unfamiliar, uncomfortable process. In reality, therapy is about developing a calm and safe interchange of ideas and emotions.
16. “I Am Too Old To Change”
Some believe that personal growth is only for the young. But therapy can be transformative at any age, whether someone wants to heal from the past, improve current relationships, or simply feel better day to day.
17. Distrust of Therapists
Unfortunately, some people assume that therapists are only in it for the money or won’t honor confidentiality. Validating these concerns and emphasizing that most therapists genuinely want to help can begin to rebuild trust.
18. A Bad Past Experience
Unfortunately, one negative experience with a therapist or counselor can sour a person on the idea of talking with someone again, especially for people who were “forced” to attend therapy during their adolescent years.
By providing a positive and nurturing environment, a therapist can help undo some of the negative scripts that a person has built up based on a single experience. Emphasizing the empowerment that comes from deciding to seek help can be especially beneficial for a patient who has previously been forced or coerced into seeking therapy.
19. Fear of Change
People struggling with substance abuse or unhealthy romantic relationships might avoid treatment because they have become so accustomed to the dysfunction. When someone is trapped in these behavior patterns, the idea of getting better can be terrifying.
Many people incorrectly think that a therapist cannot work with them if they are ambivalent about getting help. They believe they have to be completely ready to make a change before they receive mental health care.
Therapists often have to assure potential patients that therapy is not about pushing someone to make a life decision in one direction or another. It is about talking through those decisions in an atmosphere that supports healthy change.
20. “Talking Won’t Help”
Many people wonder how simply talking about problems can make a difference. But research shows that the therapeutic process helps people feel heard, understand themselves better, and develop tools to manage life’s challenges.
Final Thoughts
You can engage more patients at your practice by keeping in mind the reasons why people avoid seeing a therapist in the first place. Identifying and relieving those concerns go a long way toward keeping patients engaged and improving outcomes.
In Part 2 of this series, Reasons To Go to Therapy: 20 Ways To Encourage Someone Who’s Unsure, we’ll explore what to say (and what not to say) when supporting someone who’s on the fence about getting help.
Looking to improve engagement at your mental health practice? Subscribe to our blog to receive the latest industry insights, news, and resources delivered right to your inbox. And if your current EHR system could be more of an ally in managing your workload and revenue, request a demo to see how ClinicTracker can help!
