Barriers to Mental Health Treatment and How Nurses Can Intervene

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A health care provider talks with a patient.

Patients visit primary care providers, including family nurse practitioners (FNPs), for the treatment of illnesses and injuries, including common mental health concerns such as depression, substance abuse and anxiety. Unlike psychiatric mental health nurse practitioners (PMHNPs), FNPs are not exclusively mental health care providers. But they do develop care plans and, in some cases, prescribe medications for mental health patients.

FNPs provide comprehensive care to all patients, from infancy through adulthood, so treating mental health disorders is well within their scope of practice. Registered nurses (RNs) who become FNPs must be prepared to assist patients with mental health disorders, particularly as FNPs earn the right to autonomous practice.

FNPs can be effective in managing mental health issues because they treat symptoms without bias or judgment and focus on a holistic approach that addresses external factors, such as poor nutrition and work stressors, which can fuel symptoms of depression and other mental health disorders.

As primary care providers, FNPs work across a variety of settings to evaluate patients, make diagnoses and initiate treatment plans. Nurses who are seeking an advanced education should learn about the importance of holistic care in treating mental health disorders and other ailments. It is equally important for them to understand the barriers to mental health treatment that prohibit patients from seeking out the help they need.

How to Get Help with Mental Health

There are several ways a person dealing with a mental health issue can get help. WebMD lists several types of health care professionals who provide specific levels of mental health aid when needed, including:

  • Psychiatrists and psychologists
  • Social workers
  • Primary care doctors
  • Nurse practitioners, such as FNPs or PMHNPs
  • Physician assistants

There are also resources devoted to helping individuals who are dealing with severe forms of depression, such as people dealing with suicidal thoughts. The National Institute of Mental Health offers a host of resources where those grappling with overwhelming depression can find immediate help. Some resources are designed to help specific population demographics, such as veterans or people experiencing distress due to a natural or human-made disaster.

Barriers to Treatment for Mental Health

The most recent data from Mental Health America reports that more than 47 million adults ages 18 and older (or about 19%) are experiencing mental illness of some sort, and about 4.5% of adults are experiencing severe mental illness. More than 26 million adults (roughly 57%) did not receive any medical help for their mental health issues. The causes of these issues range from workplace stress to childhood trauma.

Studies report a variety of reasons patients did not receive the proper treatment, including:

Cost of Treatment

People in need of mental health assistance may not be able to afford it. Lack of health insurance coverage contributes to this issue.

Lack of Awareness

Some patients may not be fully cognizant of the severity of their mental health issues, and so may not give them the appropriate level of attention.

Personal Feelings

People experiencing mental health issues may be overwhelmed with feelings of hopelessness about treatment prospects, which can hinder their motivation to seek treatment.

Lack of Time in Personal Schedule

Individuals may feel treatment adds one more item to their calendars. As such, they may cite a lack of time in their personal schedules as the element that prevents them from getting treatment. This could correspond to the issue of not being fully aware of the issue’s severity.

Treatment Strategy Concerns

Some individuals express worries about having to take medications as part of a long-term treatment strategy. Others may be concerned about being committed to an institution.

Privacy Concerns

People may be concerned that there will be a breach in confidentiality during mental health treatment. This breach, they fear, may impact their lives negatively outside of a treatment environment.

Social Stigma

Some people fear the effects of negative societal perceptions about mental health problems and may feel that seeking treatment could cause them to be ostracized.

Living in Rural Areas

For the millions of people who live in rural areas where access to providers is limited, mental health treatment is even more difficult to obtain. About 144 million people live in 6,168 Health Professional Shortage Areas (HPSAs) as designated by the U.S. Department of Health and Human Services’ Health Resources and Service Administration database. The data suggests that roughly 7,200 qualified health care practitioners are needed to fill the gaps caused by the shortage.

Some concerns unique to rural patients include the following:

Accessibility Concerns

Some rural patients may lack access to transportation to health care facilities that often are a significant distance from where they live, which can limit their ability to receive care. Others may not be able to take time off from work to travel to appointments.

Language Barriers

Some patients may lack the confidence to clearly communicate their mental health issues to a professional. This can be particularly true for patients with poor health care literacy or those who do not speak English.


Some patients may harbor a lack of trust toward health care professionals administering mental health treatment. This concern can potentially cause issues if they do eventually seek treatment, as a lack of trust may hinder a provider’s ability to give comprehensive treatment.

How Nurses Provide Care for Mental Health Patients

The Centers for Disease Control and Prevention (CDC) reports that mental and physical health are interconnected, and primary care is essential for mental and physical health. Researchers have found that poor mental health leads to poor physical health, and people with severe mental health problems, such as depression or schizophrenia, are at an increased risk of early death.

For FNPs to properly treat common mental health disorders, they must use evidence-based treatments, psychotherapy and possibly psychopharmacological therapy. This treatment can include regular patient screenings to check for mental health problems and may incorporate progressive concepts that connect the mind and body.

For instance, a 2021 report published by Public Health Nursing suggested integrating the use of urban green spaces into treatment strategies for adolescents and young adults may have positive results. The rationale behind the use of green space is that it gives patients in urban areas recreational opportunities that can encourage them to engage in healthy habits, which can lead to improvements in mental health.

When treating mental health patients, FNPs must be cautious to work within local and state laws and their scope of practice as designated by the American Nurses Association (ANA), the American Association of Nurse Practitioners (AANP) and other nursing organizations. For example, an FNP working in a psychiatric facility and managing the physical health of patients is working within their scope of practice. An FNP working in the same facility and managing the patient’s mental health is working outside their scope of practice.

Help Set Others on a Path Toward Mental Wellness

Mental illness is no longer an issue to be swept under the rug. Discussing and treating mental health issues are crucial to helping people live better, happier and healthier lives. Nurses such as FNPs and PMHNPs can be key to a patient’s journey toward improved health.

A Duquesne University online post-master’s nursing certificate can prepare you to be a difference-maker in other people’s lives. Our curriculum is designed to further fortify your knowledge and skill set, giving you the tools you need to treat patients’ mental health effectively in urban, suburban and rural areas. Learn how we can help get you prepared to shape the future of health care.

Recommended Reading

Helping Patients Get the Medications They Need

What Are the 6 Principles of Trauma-Informed Care?

What Is Trauma-Informed Care?


American Psychological Association, “Why People Aren’t Getting the Care They Need”

Centers for Disease Control and Prevention, About Mental Health

Health Resources and Services Administration, Shortage Areas

The Journal for Nurse Practitioners, “Should Primary Care Nurse Practitioners Routinely Screen for Depression?”

Mental Health America, “Prevalence of Mental Illness 2021”

National Institute of Mental Health, Help for Mental Illnesses

Public Health Nursing, “Urban Greenspace Use Among Adolescents and Young Adults: An Integrative Review”

Rural Health Information Hub, Healthcare Access in Rural Communities

Substance Abuse and Mental Health Services Association, “Key Substance Use and Mental Health Indicators in the United States: Results From the 2020 National Survey on Drug Use and Health

Verywell Mind, “Causes and Risk Factors of Depression”

WebMD, “How to Get Help for Mental Health”