Governments, Organisations, Schools and Support Agencies are all trying to address stigma and barriers to accessing mental health care. Stigma arises out of negative attitudes, opinions, and stereotypes and may lead to discrimination against anyone with any form of mental illness. It is a key influence on people who seek help and it affects the timeliness of their help-seeking.
In this article, we review an article, published in 2017 in the Journal of Psychiatric Research, that looks at mental health stigma and barriers to seeking help. It uses, as a case, the habits of first responders. The key barriers to help-seeking by this group are:
- Fears regarding confidentiality
- Negative impact on their career
- Managing help around their job
- Not knowing where to seek help
Barriers to care for mental health issues, including not knowing where to seek help, and stigma around mental illness can lead to delayed help-seeking. Failure to seek help, or delaying to seek help, slows the recovery time and can lead to serious events such as suicide.
Barriers to Receiving Care
There is evidence that people with mental health difficulties may not feel they need help. They are often pessimistic about the effectiveness of treatment or receive poor care and may not understand how and where to get treatment. They may delay treatment or don’t fully undergo the treatment.
In this review the most common barriers to seeking help were:
- Difficulty in scheduling an appointment – long wait times, services under pressure
- Not knowing where to get help – who to ask, what type of treatment to seek
- Getting time off work – shortage of after-hours appointments
- Leaders discouraging treatment – staff shortages
- Not having adequate transport – clinics and services are generally not located on public transport routes.
But with all that said, it’s the stigma that is most frequently identified as a barrier to seeking mental health care. Stigma leads to avoidance to seek help and negatively impacts on treatment outcomes. Stigma can take three forms:
- Public Stigma – where a person is aware of the stereotypes attached to people who use mental health services
- Self Stigma – where a person applies public stigma stereotypes to themselves
- Label Avoidance – where a person refuses to acknowledge their symptoms or participate in mental health services because they fear negative consequences may arise if they receive a formal diagnostic label.
In this review, the most common barriers to seeking help associated with stigma were:
- Confidentiality – the fear that someone would find out that the person was receiving treatment
- Negative career impact – the fear that by receiving treatment and key people coming to know about it at work would jeopardise their promotion opportunities
- The judgement of co-workers – no longer being treated the same by colleagues.
First Responders’ Barriers to Mental Health Care
First responders are professionals who generally put themselves at risk first. Police officers, firefighters, emergency rescue personnel such as military officials, ambulance operators and paramedics have physically and mentally taxing jobs. The intensive nature of these jobs combined with stigma and barriers to care results in many individuals with mental health difficulties not pursuing treatment or delaying their treatment.
In this review, one-third of first responders experienced stigma regarding mental health and 9.3% reported that they have experienced barriers to mental health care. Rates of stigma were found to be higher in first responders than in the general population. Continued delay in treatment can result in elevated levels of stress, anxiety, depression, substance misuse and increased rates of suicide, putting this group at greater risk. In Australia, the average stress claim costs almost $55,000 in workers compensation with an average of 14.8 weeks off work.
The authors have recommended five structural actions that may mitigate stigma and barriers to care:
- Offer psychiatric assessment and care in general health care settings instead of district mental health sites to encourage less local knowledge of a person receiving treatment.
- Make that assessment and care routine, rather than based on symptoms, e.g. annual monitoring programmes.
- Offer assessment, feedback and treatments based on bio-behavioural monitoring, e.g. heart rate variability.
- Offer easily accessible self-screening tools and secondary prevention tools online and by digital applications.
- Rely on medical models of psychopathology to mitigate stigma and self-blame.
Online and Digital Prevention Tool
Tap into Safety’s mental health solution is an example of a prevention tool to mitigate stigma and barriers to care. The workplace solution is accessible online or on smart devices.
For businesses investing in workplace mental health, Tap into Safety helps by intervening early to support worker mental health better by providing relevant and interactive workplace wellbeing training. The solution offers ‘one click away’ from help to reach out for support (on average only 5% access their Employment Assistance Provider when 20% have an issue right now – stigma plays a huge role here).
Clients have experienced a 100% increase in help-seeking activities when using our solution, as part of their wellbeing programme. By attacking stigma head on and encouraging help-seeking early, we reduce the escalation of serious stress claims. This supports employees to reach out to seek care when they are not feeling as good as they should.
Why not try a free demo?