Hello and welcome back to The Therapist Diaries,
Well... here we are. The final post in our Suicide Awareness and Prevention Month series. It’s been a meaningful ride... heavy at times, but necessary. We’ve talked about what to look out for in ourselves and the people we love, how to build a safety plan when things feel unsteady, and who tends to be most at risk. My hope is that through this series, you’ve felt a little more informed, a little more seen, and a little more empowered- whether for yourself or someone you care about.
For this last entry, I'm getting personal and honest one more time because despite all the awareness, all the conversations, all the resources slowly becoming more available, we’re still not seeing suicide rates drop the way we’d hoped.
So today, we’re talking about one of the biggest reasons why: the barriers to treatment.
Let’s unpack it.
I think as a therapist the topic of barriers to treatment feels really personal to me because I can’t count how many times, I’ve spoken to someone who wanted help, who needed help, but couldn’t actually get it. Not because they weren’t “ready” or “motivated enough,” but because the system wasn’t built with them in mind. In America this could be issues like a language barrier, or the rising cost of health care and the rising number of people who are uninsured. In England, we're talking about an approximate wait of 18 months before you can see a mental health provider. Which, by the way, is significantly longer than the wait time to see a provider for a physical ailment.
This is why we’re talking about today, to raise awareness of those real, tangible barriers that stand between people and the care they deserve, and how we can start breaking those down.
I want to focus on three of the barriers I see most often, but as we dive in, you’ll probably notice others popping up too. The reality is, there are so many obstacles standing between people and the mental health care they need, and when therapists do assessments, they have to keep all of these in mind. You might be wondering, what can I do to help? The answer is: advocate. If you’re someone who’s politically engaged, use your voice to push for better access and funding. If you’re quieter by nature, create a safe, non-judgmental space where people feel comfortable opening up when they’re struggling. Help others find the support they need. You don’t have to have all the answers, just being willing to listen and show up makes a real, meaningful difference.
We're starting off with one barrier that I think everyone overlooks. Transportation. It seems simple, but for many, especially those in rural areas or underserved communities, just getting to therapy can be a major hurdle. This also applies to those with physical limits too. Public transit might be unreliable or non-existent, clinics are miles away, or there’s no way to take time off work (which is another barrier itself) or arrange childcare (also a barrier). The cost of gas and the stress of travel add up, making even the first step feel overwhelming.
Thankfully, there are some creative ways around the transport issue. Telehealth has opened doors for many, especially since the pandemic made virtual sessions more common and often covered by insurance. Some organizations even bring therapy to people through mobile clinics or community centers, meeting folks where they are. And therapists offering evening or weekend appointments can help those juggling busy schedules.
As you read this, you might notice that many of these solutions sound simple, and in some ways, they are. But the truth is, we should all still be fighting for more funding, more resources, and greater access to make these alternatives a reality for everyone. It shouldn’t fall on the people seeking help to carry that burden.
Then there’s the financial barrier. Therapy isn’t cheap, and even with insurance, co-pays and deductibles the cost of a session can make it feel like a luxury rather than a necessity. Without insurance, it can seem impossible. This isn't just an American issue. In the UK due to long NHS times, more and more clients are looking to private therapists which is a heavy out of pocket expense.
When it comes to finances there are options worth exploring: many therapists offer sliding scale fees or payment plans based on income if you ask, and community clinics or nonprofits often provide free or low-cost care with licensed professionals or supervised interns. For those who work, employee assistance programs sometimes cover a few free sessions. And while apps and support groups can’t replace therapy, they offer accessible starting points for many people seeking support.
Perhaps the most complicated barrier, though, is stigma. This one lives inside us, the shame of the "label", the fear of judgment, the false belief that needing help means you’re weak or broken. In some families, cultures, or communities, these messages run deep: emotions are a sign of failure, therapy is “only for crazy people,” and asking for help means you’ve somehow messed up. It’s heartbreaking and untrue. The best antidotes I’ve found are normalizing therapy as something just like going to the doctor or gym, talking openly about mental health without apology, and seeking providers who understand your cultural background and identity (though limited providers of different ethnicities is also a barrier for some). Sometimes, just learning what therapy actually is can help dissolve fear and misunderstanding.
I truly believe if we all inform ourselves a little better, and listen a little more, then we truly can support each other, and advocate for more accessible, inclusive care. My hope is that this post, and the entire series, helps you feel less alone and more empowered, whether you’re seeking help yourself or supporting someone who is. There are paths forward, there are options, and you are absolutely worth the effort it takes to find them.
Thank you for walking this September Suicide Awareness and Prevention journey with me. You matter. Always.
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