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. Author manuscript; available in PMC: 2021 Jul 1.
Published in final edited form as: Adm Policy Ment Health. 2020 Jul;47(4):606–616. doi: 10.1007/s10488-020-01021-6
Barriers to use Reasons for dropout
  Low perceived need:   Low perceived need:
The problem went away by itself, and I did not really need help. You didn’t need help anymore.
  Structural barriers:   Structural barriers:
My health insurance would not cover this type of treatment. The therapist or counselor left or moved away.
I was concerned about how much money it would cost. The policies were a hassle.
I was unsure about where to go or who to see. There were problems with lack of time, schedule change, or lack of transportation.
I thought it would take too much time or be inconvenient You moved.
I could not get an appointment. Treatment was too expensive.
I had problems with things like transportation, childcare, or scheduling that would have made it hard to get treatment. Your health insurance would not pay for more treatment.
  Attitudinal barriers:   Attitudinal barriers:
I thought the problem would get better by itself. You got better.
I didnť think treatment would work. You were not getting better.
I was concerned about what others might think if they found out I was in treatment. You wanted to handle the problem on your own.
I wanted to handle the problem on my own. You had bad experiences with the treatment providers.
I was scared about being put in the hospital against my will. You were concerned about what people would think if they found out you were in treatment.
I was not satisfied with available services. You were treated badly or unfairly.
I received treatment before and it did not work. You felt out of place.
The problem didn’t bother me very much. Your family wanted you to stop.