You deserve quality mental health care for your treatment-resistant depression (TRD). But if you face barriers to that care, you’re far from alone. Studies show less than half of U.S. adults with mental health struggles get the care they need. Here are some of the most common hurdles and strategies to address them.
Find Culturally Aware Support
A care team who understands your background can make a world of difference in the quality of care you receive. Asking people in your community for recommendations is one way to connect with care that’s a good fit, but you can also use resources like the National Alliance on Mental Illness’s “Sharing Hope” program. And Therapy for Black Girls, Latinx Therapy, and the Asian Mental Health Collective can also help you find culturally competent care that respects your identity and experience near you.
Open Up About Logistical Barriers
If you face challenges like transportation, child care, or job scheduling, tell your care team. There may be solutions they can offer if they know the problems you face. Many clinics can offer telehealth visits, medication delivery, or other support tools to help you get the care you need. The National Helpline from the Substance Abuse and Mental Health Services Administration (800-662-4357) or FindTreatment.gov can help.
Seek What You Can Afford
Financial barriers are a reality for many Americans who need mental health care. Ask your care team about patient assistance programs for TRD medications, sliding-scale therapy, or community mental health centers. Free or low-cost clinics (search “Federally Qualified Health Centers”) can also help you access high-quality care without major financial strain. Try the Health Resources and Services Administration search engine to find a health center near you. Tools like NeedyMeds.org can also help you afford medications.
Confront Stigma
You may be part of a community where talking about mental health isn’t common. Know that taking medication or going to therapy for depression doesn’t make you weak – it shows courage. It may help you to connect online with others dealing with depression. You can take part anonymously, if that is easier for you. Try the Anxiety and Depression Association of America’s Free & Anonymous Online Mental Health Support Communities or the National Alliance on Mental Illness’s Connection Support Group.
Acknowledge Medical Mistrust
History is full of examples of mistreatment toward many different groups by the medical community. A fear or mistrust of medical professionals is understandable. Recognize it and use it to help you find someone you feel comfortable with and trust. Bring a friend or family member with you to appointments to be an extra set of ears and advocate as you seek care. Ask questions and request clear explanations about your treatment.
Insist on Understanding
You need to understand what your care team is telling you – and they need to understand you when you’re describing your symptoms and needs. If English isn’t your first language, try searching for a bilingual clinic. Or you can also ask for an interpreter or translator. Many community clinics offer translation services. At FindTreatment.gov, put a location into the “Find a Treatment Facility” field, and then filter by “language services.”
Advocate for Other Options
TRD often requires a multi-step, trial-and-error approach. If multiple medications haven’t worked for you, persist. Ask your care team for referrals to specialists who have experience with TRD and other types of procedures, such as transcranial magnetic stimulation (TMS) or infusion or intranasal ketamine that might help.
Look for Low-Cost Self-Care
Caring for yourself well on top of your TRD treatment doesn’t have to be costly. Some simple practices include time outside in nature, gentle stretches, deep breathing exercises, keeping a journal, creating art or music, and time with people you love. When you can focus some time on your overall wellness, you give yourself fuel for going through the treatments and therapies you need for your TRD.
Learn Where to Get Emergency Help
If you feel like you’re in crisis, there is help available, no matter who you are. You can call or text one of the following resources 24 hours a day, seven days a week:
- Suicide & Crisis Lifeline: Call or text 988
- Crisis Text Line: Text HELLO to 741741
- Veterans Crisis Line: Dial 988, then press 1 (or text 838255)
Show Sources
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SOURCES:
The Milbank Quarterly: “The Future of Public Mental Health: Challenges and Opportunities.”
BMC Medical Education: “Overcoming language barriers, enhancing collaboration with interpreters – an interprofessional learning intervention (Interpret2Improve).”
National Alliance on Mental Illness: “NAMI Sharing Hope: Mental Wellness in the Black/African Ancestry Communities,” “Support Groups,” “Treatment Resistant Depression.” Therapy for Black Girls.
Latinx Therapy.
Asian Mental Health Collective.
FindTreatment.gov.
The Urban Institute: “More than One in Five Adults with Limited Public Transit Access Forgo Health Care Because of Transportation Barriers.”
Rural Health Information Hub: “Transportation to Support Rural Healthcare.”
Findahealthcenter.hrsa.gov.
NeedyMeds.org.
Anxiety and Depression Association of America: “Free & Anonymous Online Mental Health Support Communities.”
National Alliance on Mental Illness’s Connection Support Group.
Interdisciplinary Association for Population Health Science (IAPHS): “What Can We Do About Medical Mistrust?”
American Psychological Association: “How Do I Find a Good Therapist?”
Mind: “Depression.”
VeteransCrisisLine.net: “Veterans Crisis Line.”
SAMHSA.gov: “Crisis Text Line,” “988 Suicide & Crisis Lifeline.”
