Barriers to Help: Q&A With a Mental Health Counselor

A few weeks ago, we asked you to tell us about the obstacles you face when it comes to getting help. We believe everyone deserves access to the mental health care they need. And sometimes guidance from a trusted individual is necessary when trying to navigate your journey toward help and healing, so we asked Licensed Mental Health Counselor Denny Kolsch to respond to some of your concerns.

Note: If you or someone you know is struggling, our FIND HELP Tool is a great place to start when it comes to locating free or reduced-cost resources in your community. The tool is free to use and we are always expanding our database by adding new resources. If there’s a resource you think should be included, email our team at [email protected].

“My campus offers excellent mental health services, but the waitlist to see a therapist is so long that it takes almost an entire semester to get in. They’re definitely over capacity, and our university is in a rural area that isn’t equipped otherwise to handle the volume of people.”

DENNY: This is definitely an issue in the behavioral health community and people trying to access help professionally in rural communities. I will say that what people are leaning on mostly at this point is telehealth. That’s really blossomed even more so since the pandemic began. But telehealth has been trying to make its way into the behavioral health world probably for the past 10 to 20 years, but it’s really starting to vamp up now. So with telehealth, you’re not going to get the full experience that you would get in a traditional like face-to-face talk therapy, but at the end of the day, it is evidence-based and in a lot of ways it connects people to a place to be able to explore and work through mental health issues. I will say that essentially people need other people, and people can help other people. So at the core: people need to find somebody that they can trust, that has some wisdom, that cares about them, that they feel comfortable with. And ultimately, that they can be open and transparent with.

“In my professional experience, the biggest obstacle I saw was a lack of awareness of what resources there are available for those with little to no income. I saw families who were willing to do anything to get help but didn’t even know there were services available to them.”

DENNY: This is a pretty challenging one. I take phone calls almost every day from family members typically reaching out and trying to find some kind of help for their child or a family member. They don’t really know even what to ask. In many cases, they may not have insurance. They may not have very much money. They don’t even know exactly what kind of facility or treatment the individual needs. It’s confusing and messy. So this is where we really lean on the agencies locally and nationally to be creating resources, search engines, and in promoting these so that people can access the treatment that they need more easily. For example, people can use TWLOHA’s FIND HELP Tool or SAMSHA’s Treatment Services Locator to find out what resources are available to them for free or at a low-cost rate. But systemically, there for sure is an inherent barrier. Our communities across the country and beyond need to become more creative and put more resources into educating people on how to get help, the different kinds of help, and how to get help when you don’t have much money.

And a little hot tip for those wanting to get involved with local mental health initiatives, I would say is to locate your local health department and ask them if they have a resource page for any local task forces because there’s usually a mental health task force in the community. Most communities now have opioid task forces, behavioral health task forces, and then even very specific, like domestic violence task forces, child advocacy task forces. That’s really where the organic, grassroots change on a bureaucratic and political level happens within communities.

“I think one HUGE boundary is people not knowing what kind of mental health assistance they need. They may have an appointment with a counselor or therapist but think they have an appointment with a psychiatrist and they don’t understand that until they are in an appointment and ask for a prescription. Conversely, people want to use their psychiatrist as their therapist. While these services are indeed very much related, they are separate services with specialized clinicians for each scenario. Instead of doing a mental health referral for each provider separately, I would love to see there be ONE referral for mental health services that gets a patient access to a counselor/therapist, social work or case manager, and psychiatric evaluation with medication management services if needed. By working as one interdisciplinary team we can provide the best care possible for these people!”

DENNY: This is definitely something that can confuse people. Often they will start a search online and type in therapist or counselor and a lot of times it will come up as maybe a social worker, maybe a mental health counselor—depending on the state they’ll call it a licensed professional counselor or a licensed mental health counselor. There are psychiatrists, there are psychologists, there are people that are doctors. So it can get really confusing.

Ultimately, once you start your first session or you’re going through the intake process, the professional should disclose the type of treatment they’re getting and they should disclose what kind of professional they are. So it’s a matter of asking questions, maybe even the pre-screening or the initial phone consultation stage of connecting with a therapist, and asking them what is their license and what is their specialty. You can tell them a little bit about what you’re going through and just ask them if they think you’d be a good fit.

It’s definitely about asking questions, which really is easier said than done. When you’re coming to the service with a misunderstanding or lack of knowledge about that service, it can feel pretty uncomfortable, you can feel a bit insecure about even asking questions. But ultimately you do have to ask the questions to know, but also lean on the fact that the professional should be disclosing.

“Feeling like I’m not sick enough to need it and it would be a waste of their time.”

DENNY: Whether it’s substance use or just mental health in general, the prognosis is going to be more promising if you address the issues before they become worse. It’s not much different than even a machine or a vehicle—if you keep your vehicle maintained, then your issues are usually going to be less. Yes, you’re going to have some of the wear and tear that happens and occasional unexpected issues that occur, but if you’re maintaining something in a healthy way, you’ll stay on top of it. Preventative care isn’t simply addressing something that doesn’t exist yet. It’s more so addressing something that’s on the less severe side of the spectrum or the continuum.

“Honestly just telling my parents. I understand they love me, but I don’t want to talk to them about what’s going on. My mom will grill me until I tell her, and there are things that I don’t feel comfortable telling her about.”

DENNY: If your parents, for example, are people that you feel uncomfortable talking to about this then, assuming you are an adult, you don’t have to tell them. You can reach out to other people, you can do your own research. You can lean on friends, you can lean on mentors. You don’t have to feel the obligation to disclose everything to your family as it relates to your healing process. And sometimes our families are very much a part of our pain. And it can be really challenging to even share about that because well, they have their own opinions and they can often be barriers themselves in the voicing of their opinions. So I would just say that people should feel permission to not share everything with their family.

You can listen to an extended version of this conversation on the TWLOHA Podcast here.