Alice, a copywriter and homemaker in Seattle, has struggled for 20 years with a secret shared by one in five adults in the U.S.: mental health issues. “I went through periods of deep depression and anxiety as a kid, and then while attending college, raising two sons, and maintaining a sometimes stressful career,” says Alice, 50. “For years, I lived in fear my friends, teachers, and employer would find out. The worst part was that I was too ashamed to get help.”

Ignoring these common mental health conditions can compromise physical as well as emotional well-being. According to the National Institutes of Health, a high level of emotional stress increases the risk of chronic conditions including Type 2 diabetes and heart disease. Additionally, Americans lose $193 billion in earnings each year due to mental illness. At the same time, there’s a marked lack of mental health services for those who need them most in our country.

Lack of access and a mental health crisis

According to a recent study published by the National Council for Behavioral Health, mental health services in the U.S. are insufficient despite more than half of Americans seeking help. Despite this strong demand, the overwhelming majority of Americans (74%) do not believe mental health services are accessible for everyone, and about half (47%) believe options are limited.

“Limited options, cost and long wait lists to see a therapist deter many people in emotional distress and they opt to suffer in silence,” says Karen Langer, M.Ed., LMHC, Counseling Center Director, City University of Seattle, which offers a sliding fee based on income and no waiting for an assessment appointment. “Our counselors are master’s level interns, working under the guidance of experienced staff. The goal is not just training students, but also providing a vital resource to the community.” The center’s sliding fee ranges from $0-$60 and the average client pays $10 per session, Langer says.

Reducing the stigma of mental health care

Fear and misunderstanding often lead to prejudice against people experiencing mental health issues, adding to their sense of shame and hopelessness. “I was bullied as a kid for being overweight and easy to make cry,” says Alice. “I learned to be extremely quiet, hoping no one would notice me — which, of course, fueled both depression and anxiety.” Like Alice, many people try to fake “normal,” avoiding using their health insurance benefits and seeking treatment altogether.

“It’s not uncommon for almost everyone, at some point in their lives, to struggle with depression or anxiety, impacting their school and work performance, relationships and sense of self,” Langer says. “They don’t seek help until they feel like they’re out of options, their lives fall apart and they’re desperate. If mental health could be seen as self-care, instead of being ‘sick’ and ‘crazy,’ many people would ask for help sooner — and feel better sooner.”

So how do we reduce the stigma of mental health? Alice started by talking openly with her friends and family members about how she was feeling. “One of my friends opened up about her fight with depression, so I decided to try being more honest with my husband and a few close friends,” says Alice, who made it clear she didn’t want advice. “I just wanted people I was close with to know I was struggling, give me a hug and listen — listening is huge!”

Langer suggests that if there’s someone in your life who is going through emotional distress, educating yourself about their condition may be helpful. She also suggests becoming aware of the options that are available in your community, and even offering to help by making an appointment with a counselor and driving to the assessment appointment. “Dealing with mental health issues is exhausting and confusing,” Langer says. “The biggest support you can give is letting someone you care about know they aren’t alone.”

When to consider counseling

“Mental health isn’t just for when you’re in crisis,” Langer says. “Often therapy is beneficial in preventing a situation from spiraling out of control.” Common mental health issues Langer sees include:

  • Stress
  • Anxiety
  • Depression
  • Relationship issues
  • Personal setbacks
  • Career matters
  • Financial challenges
  • Grieving and loss
  • Physical pain

City University of Seattle offers a sliding fee, based on income, ranging from $0-$60. (The average client pays $10 per session.)

City University Counseling Center serves the entire community, offering a sliding fee based on income. Counselors are master’s level interns from City University’s Master of Arts in Counseling program, under the supervision of staff with extensive experience.