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Getting Started is the Hardest Part: New Research Reveals Keys to Overcoming Barriers to Mental Health Care for Consumers

Stigma and fear substantially higher among previous patients than those yet to experience mental health care services

MIRAMAR, FL, December 16, 2021 – Propelled by increases in mental health issues and sustained usage since the onset of the COVID pandemic, new research released today reveals new insights into the key drivers of behavioral health service usage, some of which may contrast with previously held beliefs; and points to new challenges consumers face in accessing behavioral health services to address their needs.

According to the research, released by national virtual care provider MDLIVE, an Evernorth company, 7 in 10 consumers experience uncertainty and confusion when considering starting behavioral health care. The research was revealed for the first time today as part of a virtual presentation to members of America’s Health Insurance Plans on improving consumer engagement with behavioral health care.

This, along with other factors, may be contributing to dissatisfaction among some consumers who have sought behavioral health care services in the past. Approximately 6 in 10 (61%) study participants who have had behavioral health care in the past indicated they were either unsatisfied or only somewhat satisfied with their care.

The wide-ranging study polled 1,000 U.S. consumers between the ages of 18 and 75 who currently use or are open to using behavioral health care services.

“When it comes to seeking behavioral health care, getting started is the biggest issue. This study illuminates the challenges people face, what has been daunting about the process traditionally and, most importantly, what we can do to address those challenges,” said Dr. Cynthia Zelis, chief medical officer, MDLIVE. “Our programs are breaking down the barriers to consumers getting the mental health care they need. We’ve seen nearly 70% year-over-year growth in behavioral health visit volume in 2021, and 78% clinical improvement after three sessions with an MDLIVE therapist.”

Perhaps most surprising, the report revealed that issues of stigma and fear exist at substantially higher rates among people who have participated in mental health care services previously compared to those who have never used mental health services but are open to it. The proportion of consumers citing stigma as a barrier to seeking behavioral health care in the future was 68% higher among past behavioral health care users versus non-users, and fear was reported by nearly twice as many past users versus non-users.

The report delved into the specific contributors to the uncertainty and confusion felt by many. One in 3 study participants who are not engaged in behavioral health care but are open to it report they don’t understand the desired outcomes of behavioral health care, which is a critical cornerstone of engagement between a patient and provider. That uncertainty extends to finding a provider to begin with: 1 in 4 consumers reported being dissatisfied with provider availability and 1 in 5 revealed concerns over finding a provider match. One in 6 in the study reported being overwhelmed by the number of provider options available.

“One of the most insightful findings of this research is that behavioral health care services continue to have a stigma associated with them that contributes to an overall branding challenge,” said Dr. Zelis. “Consumers seek optimism and hopefulness, as well as support with the process of getting care, including deciphering between types of providers and navigating how to get started. Behavioral health care needs to be framed in terms of what consumers are seeking and how they define their situation, not labeling them with the clinical terminology.”

The research revealed a widespread lack of understanding of the different types of behavioral health providers and their roles, which may make the process of finding a provider even more daunting. Among people open to using behavioral health services, only 40% understand what a therapist offers and 39% understand the role of a psychologist. The confusion exists even among those who have had behavioral health care services in the past: just 50% understand the role of a psychologist and only 44% understand the role of a counselor. A mere 35% understand the role of a mental health coach.

When queried on the key triggers, nearly half (48%) of consumers in the study reported “coupling and decoupling” – getting married, facing relationship challenges and separation or divorce – as a chief reason they are seeking care, while 43% reported grief and loss as a key trigger. Nearly one-third (31%) reported career or job shifts as a trigger, while 26% reported family changes such as a new baby or a family member illness as a trigger.

MDLIVE offers simple, convenient, affordable virtual health care services to over 60 million members nationwide. Our network of board-certified physicians, dermatologists, psychiatrists and therapists are specially trained in virtual care and are committed to the highest quality treatment and the best possible patient experience. We leverage technology and artificial intelligence to simplify and streamline, connecting providers and patients whenever and wherever it’s most convenient, often within just minutes. To learn more about our expanding product suite and our partnerships with major health plans, hospital systems and employers, visit, download our app, or text “Sophie” to MDLIVE (635483) to register.


Amy Trow, (412) 377-3771

Coyne PR
Kevin Lamb
Ann Smith

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Amy Trow