What is holding you back? 
November 2022 | The Learning and Wellbeing Team

Psychotherapy. Counselling. Mental health coaching. Each year, some million Canadians and over 41 million Americans get some form of professional help for mental health difficulties and needs.  That’s a good start, but there is a way to go. Still, about 50% of individuals with mental health needs reported not receive enough help or any help at all.   

Getting help is hard. The pathway from having a mental health difficulty to knowing you have a difficulty and getting help for it is covered in a number of pitfalls and hurdles.  First, you have to recognize that you have a mental health problem. Then, you have to acknowledge you need help with it. And then, you have to decide where to ask for help, what kind of help to ask for, if it is available where you are located and then actually ask.  Nothing can be more complicated.  

Barriers to getting help
Large surveys of students at college and university have found that only about one quarter (24.6%) of students, who say they need help, report that they actually get help. The top five reasons for not getting help are presented in the chart below. The main reasons for not getting help were a preference to handle the problem alone, followed by a preference to talk with friends and relatives, and feeling too embarrassed to talk about it. Cost and availability were also barriers to getting help but not the top reasons. 


Does psychotherapy and counselling work?

Research that examined the effectiveness of psychotherapy and counselling have shown that approximately 60% of young adults will experience improvement from treatment that can last years.  Other studies have shown that benefit from psychotherapy can be improve by combining psychotherapy with medication, for some conditions, such as clinical depression. 

Sixty percent doesn’t sound high enough. 
Sometimes treatment — both psychotherapy and medication — doesn’t work as well as anyone would like. If it is not working for you, it is important to talk to your health or mental health professional about it and to keep working at finding a solution. Very often, even just moderate improvement can be enough to get you up and doing things again while you work on finding that ideal outcome. 

Not sure what your barrier to getting help is? 

If you are not sure what your barrier to getting help it, take the Barriers to seeking help quiz, that was designed to help you understand what your hurdle is. 

Ask yourself:
If you are among the group of students whose barrier to getting help is among those top three, please ask yourself:

If you broke your leg … 
would you prefer to handle the problem alone, or would you see a doctor?
would you prefer to talk to your friends about it, or would you see a doctor?
would you let embarrassment keep you from going to the hospital?

Getting help is hard, but it is still the right thing to do. 

Not sure what kind of difficulty you have? 

If you are not sure what kind of difficulty you have, you could try taking any number of screening tools.  

1. Statistics Canada (2018) Mental health care needs. 
2. Terlizzi, E. P. & Norris, T. (2020). Mental Health Treatment Among Adults: United States. Center for Disease Control.
3. Eckshtain et al. (2019) Meta-analysis: 13-year follow-up of psychotherapy effects on youth depression. J Am Acad Child Adol Psychiatry. 2020; 59: 45-63.
4. Salzer, M. S., Brusilovskiy, E., & Townley, G. (2018). National Estimates of Recovery-Remission From Serious Mental Illness. Psychiatric Services, 69(5), 523–528. 
5. Kamenov, K., Twomey, C., Cabello, M., Prina, A. M., & Ayuso-Mateos, J. L. (2017). The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: A meta-analysis. Psychological Medicine, 47(3), 414–425. 

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