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More than 70 percent of people worldwide who struggle with mental health problems do not seek professional treatment. That reluctance leads to vast numbers of people without the care they need to function normally. What is it that keeps so many people from seeking help when they are struggling? What can you do as a therapist to help improve engagement? We will list the top 20 reasons why people avoid treatment so you can look for ways to overcome these kinds of objections.

Here are 20 reasons why people avoid connecting with a therapist.

1. The Impact of Stigma

According to research, the primary reason people avoid talking to a professional is out of fear they will be judged to be somehow inadequate or unstable. In most societies, psychiatric problems are regarded as defects in character rather than as legitimate disorders. Many people who suspect that they would benefit from talking with a professional cannot shake the fear that admitting they need help means that they belong to a category of people that society has labeled “unstable” or “untrustworthy” for decades. 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 a situation must be dire before it is appropriate to seek care. When they compare their own problems to extreme cases, it is easy to feel that their problems are not severe enough and that they do not need to seek care. For care providers, the task is to create awareness that mental health support is not intended to be a last-ditch effort reserved only for those who are catastrophically impaired.

3. It’s Too Expensive

Many people fear the financial cost of seeking help. Of course, that can be a legitimate concern for many. However, potential clients can be unaware of insurance options and payment plans. They also might not see mental health support as a worthy investment given how society so often devalues mental health wellness.

4. I’m Too Busy

Therapy-avoidant people can use a busy schedule as an excuse for failing to engage a therapist. They might not consider that they are working harder or more inefficiently than necessary because of mental health symptoms. They might also not realize that, with the pandemic, convenient and cost-effective telehealth options have been prevalent.

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 person’s mental health problems have 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

Most 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 relate their experiences. Families seeking help inevitably worry that the clinician is intent on identifying all the ways the parents have damaged their children. Therapists often do well to anticipate these reactions by discussing them with clients at the outset of therapy.

7. Medication Should be Enough

Talking about problems or learning coping strategies can involve no small amount of effort and discomfort. The idea of solving all one’s problems with a pill or two can seem like an attractive alternative. However, few mental health conditions are best treated with medication alone. And even conditions for which pharmacotherapy is the primary intervention require adjunctive treatments. Furthermore, therapy can be used to help patients move away from medications, a worthy goal given that some medications have long-term side effects.

8. I Want Certain Topics Off Limits

Some people stay clear of therapy out of concern 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 “forbidden” topics at their own pace.

9. I Feel Like I would Betray the People I Love

A prospective client sometimes worries that therapy will lead them down a path of betrayal, because they would talk critically about people they love. 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. It is essential to assure the person that therapy is not gossip. It is learning to cope with one’s experience and those who have caused pain.

10. I Don’t Need Help

People suffering from mental health problems are not always aware that they could use help. They might be too confused to know, sadly immune to the pain, or just of the mind that misery is the way of the world. Some deny their own problems by blaming others as the ones who require assistance. And still others have problems identifying how their own behavior can cause harm to self or others.

11. I Don’t Want to Prove That People Were Right to See Me as Struggling

In some cases, a person is reluctant to seek help because they have been told for years that they were “bad” or “wrong.” In their mind, going to therapy would simply validate that view. Shining a positive light on therapy as a “tool” instead of a “punishment” is essential.

12. I Deserve My Unhappiness and Pain

Even when people know that they need support, they can feel too ashamed or belittled to believe they deserve a good life. A person might think that they warrant or 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 therapy 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 that 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. Messaging that focuses on how therapy can tackle many issues that create many different emotional experiences is vital for helping these people realize that they can benefit from receiving treatment.

15. The Idea of Getting into Therapy Makes Me Nervous

The fear of trying something new can hold many people back from seeking help, especially those who are anxious by nature. From the outside, therapy might seem like it is a secret club with its own customs and rules. The way movies and other media portray therapy can also make it seem like an odd and stressful enterprise. In reality, therapy is about developing a calm and safe interchange of ideas and emotions.

16. I am Too Old to Start Now

Individuals who are middle-aged or older can feel like they are like old dogs who will not ever be able to learn new tricks. They assume that the time to work on yourself is when you start a new life, new relationship, or new career. Therapists have the task of reminding potential patients that it is never too late to resolve life’s problems and improve one’s functioning.

17. Therapists Just Want My Money

A shocking number of people distrust therapists. They can believe that providers are only interested in the income they generate from seeing patients (an ironic stance given the average income of most therapists and counselors). They also can be suspicious of a therapist’s adherence to rules around confidentiality. Much of the initial process of engaging a new patient is hearing them out around these kinds of concerns.

18. Been There, Done That, No Thanks.

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 to 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. Change Scares Me

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 patterns of behavior, 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 can get help. 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 about those decisions in an atmosphere that produces healthy change.

20. How Can Talking Help?

Laying down on a couch and talking about one’s problems has become the iconic portrayal of psychotherapy in the movies. Many clients believe therapy simply involves endless chatter. They do not understand how laying on a couch and talking about one’s problems can help — especially when they believe the problem to be insurmountable. They may see each therapy session as a waste of time.

It is vital to assure patients that talking about the problem helps the therapist understand the problem. It also helps the patient manage negative emotions and develop coping skills to deal with the issue. Emphasis should also be placed on the fact that there often is not a quick fix. Therapy is a process that takes time.

Final Thoughts

You can engage more patients at your practice by keeping in mind the reasons why people avoid treatment. Identifying and relieving those concerns go a long way toward increasing client retention.

Do you want more advice on how to manage your mental health practice? Check out all of our helpful blog posts and resources. If your current EMR system could be more of an ally in managing your workload and revenue, take a look at ClinicTracker’s powerful mental health EMR today!