Understanding Barriers to Mental Health Care: A Clinical Perspective

Accessing mental health care should be a pathway to healing, stability, and connection. Yet for many youth and families—particularly Black youth and families and others from historically underserved communities—that pathway is often shaped by systemic barriers, stigma, and prior experiences that make seeking care feel inaccessible or unsafe.

As a behavioral health organization working closely with youth and families, we understand these challenges not as a lack of willingness to seek help, but as the result of systems that too often fail to meet people where they are. For Black youth and families in particular, barriers to care are often compounded by the legacy of racial inequities across health care, education, and child-serving systems. Experiences of cultural misunderstanding, institutional mistrust, and responses rooted in surveillance or punishment rather than care can deeply influence whether families feel safe seeking mental health support.

This perspective is shaped by our evidence-based work with youth and families across our programs, such as the East Bay Wraparound Program, and informed by the insights and lived experiences of our clinical staff, including Nicole Austin, Division Director of Family-Based Services and Licensed Marriage and Family Therapist, and Dillon Smith, Care Coordinator and Mental Health Therapist.

One of the most common challenges families’ shares is the difficulty of finding mental health care that feels responsive, affirming, and relevant to their lived experience. When individuals do not feel seen, heard, or understood in care settings, it becomes difficult to trust the process or believe that services will truly meet their needs. Over time, this disconnect can discourage families from seeking or continuing care—not because support is unnecessary, but because the system itself feels unwelcoming or ineffective.

“When people don’t feel seen, heard, or affirmed in care, they stop accessing it—not because they don’t want help, but because the system isn’t meeting their needs. Families shouldn’t have to carry the emotional labor of explaining their lived experiences when they’re seeking healing.”— Nicole Austin, LMFT, Division Director, Family-Based Services

In addition to relational barriers, families often encounter practical obstacles that limit access to care. The cost of services, limited insurance coverage, long waitlists, and provider shortages can make it difficult to receive timely and appropriate support. Even when families actively seek help, eligibility requirements or funding limitations can result in care being delayed or denied at moments when it is most needed.

Stigma remains a powerful barrier to seeking care. In many communities, there is pressure to appear strong, resilient, or high-performing—sometimes accompanied by the belief that needing therapy is a sign of weakness. Families are also sometimes encouraged to rely solely on faith or prayer, rather than seeing mental health care as something that can complement spiritual or community supports.

There are also widespread misconceptions about therapy itself. Many people still think of therapy as “talk therapy” aimed only at correcting behavior. In reality, mental health care should take a holistic approach, supporting emotional regulation, nervous system health, trauma recovery, and overall well-being. When care is framed through a limited or Eurocentric lens, it can feel disconnected from how individuals experience stress, grief, or emotional pain.

“Many youth and families don’t come in saying, ‘I’m depressed’—they talk about being exhausted, overwhelmed, or always on edge. What helps them engage is feeling safe, knowing they won’t be judged, punished, or misunderstood for asking for support.”— Dillon Smith, Care Coordinator III & Mental Health Therapist

Historical trauma and systemic inequities further influence whether families feel safe seeking care. Asking for help requires vulnerability, and for many, that vulnerability is shaped by past interactions with institutions that responded with punishment or surveillance rather than support. Families may worry that sharing concerns could lead to unintended consequences, while youth may experience mental health needs being met with discipline instead of care. Shame—both internal and external—can further prevent families from accessing the support they need.

Despite these barriers, engagement becomes possible when care environments are rooted in empathy, validation, and respect. Families are more likely to seek and remain in care when they feel genuinely heard, when their concerns are taken seriously, and when they are met without judgment. Supporting emotional regulation, acknowledging lived experience, and approaching care with curiosity rather than assumption all contribute to stronger therapeutic relationships. When individuals feel affirmed in who they are, mental health care becomes not only accessible—but meaningful.

Preserving our cultural legacy means recognizing both the resilience communities carry and the responsibility systems have to meet people with dignity and care. At Fred Finch, this work is ongoing. By listening closely to the experiences of youth and families and continually examining how services are delivered, we move closer to a future where mental health care is truly accessible and supportive for all.

As we observe Black History Month, we recognize that addressing the barriers facing Black youth and families cannot be limited to a single month or moment in time. These barriers are rooted in history and sustained by systems that continue to shape access to care today. Honoring Black history means not only recognizing the resilience of Black communities, but also committing—year-round—to reflection, accountability, and action. At Fred Finch, this commitment is embedded in our ongoing cultural responsiveness and advocacy work. By listening closely to the experiences of Black youth and families and continually examining how our services are delivered, we move closer to a future where mental health care is truly accessible, affirming, and supportive for all.

About East Bay Wraparound Program: The East Bay Wraparound Program offers personalized, community-based support for youth and their families. The program helps strengthen family connections while addressing the unique needs of each child through counseling, guidance, and coordination of services. Participants receive a mix of clinical and practical supports aimed at promoting stability, resilience, and overall well-being. This includes:

• Developing safety plans and behavioral strategies

• One-on-one and family coaching

• Connecting families to local resources and community services

• Identifying needs related to housing, education, and career development.

Services are delivered directly by dedicated program staff, who work closely with families to create a Child and Family Team (CFT) that sets priorities and guides care. Learn more about the East Bay Wraparound Program