September is Suicide Awareness and Prevention month, and individuals are sharing the barriers they face in mental health treatment.

While mental health has become less stigmatized over the years, there are still significant challenges for many in accessing care.

Aarushi Dervesh, a University of Iowa senior studying neuroscience, has been diagnosed with ADHD, generalized anxiety disorder, and major depressive disorder. She said her mental illnesses have impacted her schoolwork.

“Even in high school, I had to get pulled out of classes because teachers were concerned about how I was doing,” Dervesh said. “Obviously, we’re in college now. That’s not what professors are going to do. I feel like I have to do that for myself sometimes.”

Dervesh said she had to postpone exams and assignments. She claimed that once, a professor even took off points for an assignment she missed because she needed a second extension due to influenza, which she said worsened her anxiety.

“It’s a lot harder to balance the things people expect you to do to be a good student, especially if you are applying to grad school,” Dervesh said. “It’s really frustrating because things take you so much longer.”

Dervesh said she sees a psychiatrist at UI Student Health and receives accommodations set by Student Disability Services. She said she once tried to use University Counseling Services, but they were booked for the day and told her to come back the next day.

Barry Schreier, director of UCS, said the counseling center has a long waitlist due to being short-staffed. He said a barrier college students face in mental health treatment is finding the time in their busy schedules to go to therapy.

“People who don’t need [mental health treatment] can’t understand what kind of a time commitment it is,” Dervesh said. “That, I think, becomes a barrier because people assume we have so much more time in our day than we actually do.

UCS offers limited one-on-one counseling sessions. Outside of the university, therapy can be particularly expensive, especially for those with more than one diagnosis, which can increase cost. People with comorbidities — having two diagnoses at once, such as ADHD and anxiety — have increased health care costs, according to a 2010 study.

Lack of representation a barrier

A lack of representation may also be a barrier because people don’t see themselves represented. Schreier said students of color and members of the LGBTQ+ community might feel that way about the UCS staff.

Stigma and stereotypes can also affect how people seek out mental health care. Venise Berry, professor in the UI School of Journalism and Mass Communication, is planning to call for submissions for an anthology book that will focus on how the “Strong Black Superwoman” stereotype impacts Black women’s mental health.

“Not only is that stereotype problematic in the sense of how people view Black people, but unfortunately, Black women have a tendency to try to expect it,” Berry said.

The “Strong Black Superwoman” stereotype is sometimes characterized by suppressing emotions, feeling an obligation to help others, resisting vulnerability or dependency, and a determination to succeed despite limited resources, according to a 2010 study.

Berry said research shows that Black women tend to struggle more with anxiety and depression. In a study from the U.S. Department of Health and Human Services, Black girls in grades 9-12 were 60 percent more likely to attempt suicide than non-Hispanic white girls of the same age.

“[Black women] tend to take care of everyone but themselves,” Berry said.

Berry said a barrier women face in mental health treatment is hesitation to seek help.

“There’s this notion that you don’t give in to mental issues, that you ignore them,” Berry said.  “You don’t want anybody to think you are crazy.”

LGBTQ+ youth also struggle with access to mental health resources.  Age restrictions, inability to pay for treatment, and no transport to treatment, are reasons many youth receive mental health services from primary care providers instead of secondary mental health service providers, according to the Center for American Progress.

Oftentimes, LGBTQ+ youth tend to receive treatment from a primary care provider instead of a mental health professional because they fear a new professional will not support their identity.

According to the Centers for Disease Control and Prevention, LGBTQ+ youth attempt suicide at three times the rate of their peers, and they are five times as likely to commit suicide.

However, a supportive environment can lower those odds. In a 2011 study of lesbian, gay, and bisexual youth, they were significantly less likely to attempt suicide when they were in an environment that supported and respected their identity.

While barriers to mental health care exist, a few places on campus outside of UCS also offer resources for marginalized groups, including The Afro House, which is available to students of color, and LGBTQ+ students may visit the Pride Alliance Center, Pride House, or the LGBTQ+ clinic within UI Hospital and Clinics.

Men often overlooked

A research study found embracing certain aspects of masculinity, such as self-reliance, were associated with poor mental health and suicidal thinking.

Men are more likely to view seeking as help as undermining societal expectations to be strong and self-reliant. Men may also be less likely to seek help the worse their mental state gets.

The rate of suicide is highest in middle-aged white men. In 2019, white men accounted for 69.38 percent of deaths by suicide. A 2018 World Health Organization report found in high-income countries, three times as many men die by suicide compared to women.

The American Foundation of Suicide Prevention found men were 3.56 times more likely than women to die by suicide. Mental Health America  found more than 6 million men in the U.S. have symptoms of depression every year, and more than 3 million experience an anxiety disorder.