When Someone Refuses Help: Navigating the Challenges of Resistance to Treatment
What do you do when someone you love refuses to get help?
Every time you bring up the idea of getting treatment, you’re met with a stubborn wall of resistance. It can be frustrating, overwhelming, and sometimes, exhausting.
If you’re going through a situation like this, you’re not alone. Tens of millions of people are affected by mental health challenges each year in the United States. But only about half of them actually go on to get help.¹
It’s normal to feel ill-equipped to deal with treatment avoidance when it’s a person you care about. It’s also very normal to not know what to do when someone refuses mental health treatment. But despite the normalcy, it can still be an incredibly stressful situation.
Fortunately, help is on hand. On this page, we’ll take a deep dive into:
- The reasons why people refuse mental health treatment
- What you can do, including strategies for overcoming resistance to treatment
- How to cope effectively when a loved one refuses treatment
- Getting support today
Reasons Why People Refuse Mental Health Treatment
People can refuse mental health treatment for several reasons. Zoning in on the specific reason behind your loved one’s resistance to treatment can be helpful in identifying the best way to approach them.
1. Stigma²
One of the biggest reasons why a person could refuse treatment is the concern of stigma. They may simply not want anyone else to find out because of the perception they may be judged harshly or unfairly. Stigma can arise in several forms:
- Public Stigma: Where the fear or apprehension is about the negative/discriminatory beliefs that others may have toward the condition, and sometimes cultural/racial stereotypes.
- Self-Stigma: Where the person directs has their own negative thoughts and sometimes, internalized shame about their condition.
- Structural Stigma: Where the stigma is about perceived negativity or lack of support from governmental or private organizations, such as pushback for job opportunities or promotions if the condition were disclosed.
Stigma doesn’t just affect the individual experiencing the mental health condition. Families and primary caregivers may also be hesitant to disclose for the same reasons.
2. Lack of Awareness³
Many people aren’t fully aware of what they’re experiencing or the need for help. Some people don’t fully understand the types of mental health disorders that exist or the benefits of seeking help from professionals. Others may have concerns about taking medication or being admitted and would rather avoid discussing their challenges.
Some individuals may feel that treatment may not be beneficial. Others may feel they can manage without getting help.
3. Costs and Accessibility
The perceived high costs of ongoing mental health care or admission is another factor that can drive someone to refuse the need for treatment – they may have concerns about treatment being a burdensome financial commitment for themselves or their family members.
Traveling regularly to and from the place of therapy, especially if it’s far away, can also cause concern for individuals, although teleconsultations are fairly common these days, especially with flexible scheduling.
4. Denial⁴
Denial can be seen as a form of defense mechanism where the person tries to gain control of the situation by denying the condition exists or distancing themselves from it. The knowledge of having such a condition can be so disturbing or frightening, that they opt for self-preservation or self-protection instead. Denial can influence whether a person decides to seek help or continue with treatment.
Once you’ve identified why your loved one doesn’t want to get help, the next step is learning how to approach them. We’ve found the evidence-based LEAP method that we’ve outlined next, an effective methodology for dealing with such situations.
What to Do When Someone Refuses to Get Help
The LEAP method was developed by Clinical Psychologist Dr. Xavier Amador as a communication program to help you build a relationship with someone who doesn’t realize they have a mental health disorder, so you can facilitate them accepting treatment.5
It’s not a coercive approach where you’re forcing someone to get help. Rather it helps you get to the root cause of the problem and bring the individual to a space of self-awareness where they understand the need for treatment.
The LEAP method is divided into 4 parts:
1. Listen
Listening, in the context of this method or any social relationship for that matter, goes beyond just hearing the words. When you’re listening to what someone’s saying, you’re wholly focused on the intent behind the words, and understanding their perspective. This step is therefore crucial to learning how to segway seamlessly into the subject of treatment.
How to Demonstrate That You’re Listening:
- Pay full and complete attention to what they’re saying and avoid interrupting them until they’ve said what they want to say.
- Use open-ended questions, such as, “How have you been feeling lately?” Open-ended questions encourage people to open up as opposed to giving one-word answers, like “yes,” or “no.”
- Paraphrase or repeat what they’re saying in your own words to show understanding. For example, “It sounds like you’re feeling overwhelmed.”
- Avoid conversational styles that are argumentative or dismissive.
Here’s an example of how to use listening techniques in a conversation:
- Instead of saying, “You’re really depressed right now. You need to see a therapist as soon as possible, let me fix an appointment first thing tomorrow.”
- Try this approach: “I’m hearing that you’re feeling overwhelmed and you’re finding it difficult to cope. Can you tell me more about what’s been going on?”
2. Empathize
To empathize with someone essentially means you’re attempting to place yourself in their shoes while validating their feelings without forming judgments. When you’re really listening to someone, you can pick up on their motivations, desires, needs, and emotions — through the tone of their voice, their facial expressions, their gestures, their mood, and other cues. When you’re able to identify the underlying sentiments correctly, it can help you respond appropriately.
How to Demonstrate Your Empathy:
- Acknowledge their feelings. For example, you could say, “That sounds really exhausting.”
- Use expressions that demonstrate care but not an agenda. “I care about you and I genuinely want to understand what you’re going through.”
- Patience is key. Sometimes, breaking through resistance can take time, especially if they’ve not had good experiences with treatment previously.
Here’s an example of how to use empathy in an actual conversation:
- Instead of saying, “Oh that’s not really a problem. You just need a few psychotherapy sessions and you’ll snap out of it in no time!”
- Try this approach: “I can see that this is a struggle for you. It must be exhausting having to deal with this every day.”
3. Agree
Agreeing isn’t about expressing agreement with everything a person has said. You’re looking to find a common ground for agreement as a stepping stone toward building a relationship.
How to Demonstrate Agreement:
- Emphasize where you’re both on the same page. For example, “I know you don’t want to see a therapist. But I also know you want to feel better.”
- Show that you understand their concerns. For instance, “ I understand you’re worried about the medication having side effects. That’s a valid concern, and something we can explore together.”
- Explore fears, apprehensions, and hesitations from a space of compassion and willingness to understand.
Here’s an example of how you can agree in a conversation with your loved one:
- Instead of saying, “Therapy worked for your Uncle. Keep an open mind and give it a try.”
- Try this approach: “I understand you’re not sure therapy will help. What would need to happen for you to feel comfortable with giving it a try?”
4. Partner
This step is about collaboration. You want to emphasize that you’re ready to be with them every step of the way, and not exhort them to go about it alone.
How to Demonstrate That You’re a Partner:
- Use choices instead of ultimatums. For example, “Would you like to try an online counseling session instead of traveling to the center for a face-to-face?”
- Involve them in making the decisions by saying something like, “What kind of support would be most helpful for you right now?”
- Encourage them to see forward movement in terms of small, baby steps. For instance, “Would you be open to just one conversation with Dr. Thomas to see whether it’s something that’s working for you?”
For example, instead of saying, “If you don’t get help soon, it’s going to become more difficult for you and our family” you can say “Why don’t we figure this out together? Is there one thing that you can do that you think is manageable?”
How to Cope When a Loved One Refuses to Accept Treatment
Supporting a loved one refusing therapy can be physically, mentally, and emotionally exhausting. It’s critical to take care of yourself, so you don’t feel overburdened or ill-equipped to manage.
Here are some practical tips you can use for self-care while developing the ability to cope effectively.
1. Get Help for Yourself
Join support groups for families of those struggling with mental health illnesses – these can be onsite or social media groups. Connecting with others who are going through the same thing can help you feel like you’re not alone and that you have support. Use these groups to discuss your concerns and learn how others are coping and managing their challenges.
2. Learn More
Read up on the mental health challenges that your loved one is going through. Discuss with mental health professionals. Understanding their condition can help you feel less helpless, understand how it manifests externally, and learn ways to manage the relationship better.
3. Practice Safe and Healthy Ways to Express Your Feelings
Make time to identify and express your feelings whether it’s through talking to your friends, seeking professional counseling, exercising, meditating, or other forms of holistic therapy.
Get Support for Your Loved One
At Mission Connection Healthcare, we believe that healing doesn’t happen in isolation. We are firm advocates for family and community involvement, having seen first-hand how vital they are to successful recovery.
Our clinical foundation is fundamental to everything we do — we don’t just look at symptom relief, our aim is to help our clients create a life that’s full of hope, promise, and meaning. And that’s why we’ve been able to deliver long-term and sustainable benefits for many of our clients.
If you’re wondering how we can help you and your loved one, we offer many options to choose from. We start with a confidential assessment to understand the client’s needs and then develop a personalized treatment plan that acknowledges their unique needs and desires.
Our services include:
- Outpatient Therapy: Individual, group, and family counseling
- Intensive Outpatient Programs (IOP): For those needing structured support
- Residential Programs: For those who need intensive care and support
- Virtual Therapy Options: These are flexible and can be done from the comfort of your home
- Evidence-Based Treatments: Including, Cognitive Behavioral Therapy (CBT), EMDR (Eye Movement Desensitization and Reprocessing), and trauma-informed care, among many others.
If your loved one is resistant to pursuing treatment, hearing from a compassionate professional could make a difference. Mission Connection Healthcare is here to support both you and your loved one.
Contact us today at 866-446-3945 or get started with an initial assessment to learn more about our programs and how we can help.
Allow us to help you start the journey toward healing and wellness. We’re here every step of the way.
References
- Statistics. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/statistics
- American Psychiatric Association. (n.d.). Stigma, Prejudice and Discrimination Against People with Mental Illness. https://www.psychiatry.org/patients-families/stigma-and-discrimination
- American Psychological Association. (n.d.). Why people aren’t getting the care they need. https://www.apa.org. https://www.apa.org/monitor/2020/07/datapoint-care
- Ortega, A.N., Alegría, M. Denial and its association with mental health care use. The Journal of Behavioral Health Services & Research 32, 320–331 (2005). https://doi.org/10.1007/BF02291831
- Leap Institute. (n.d.). About Dr. Amador’s Leap. https://leapinstitute.org/about/
