Barriers to mental health care look different across your workforce

Employers may offer benefits. Leaders may say the right things. But when someone actually needs care, the real barriers to mental health tend to be practical:

• It takes too long to find care
• It costs too much
• It's not safe or private
• It's hard to know where to start

And those barriers are not the same for everyone.

As part of research for its 2026 Workplace Mental Health Annual Report, Spring Health surveyed 1,500+ full-time employees across five different countries (the United States, Canada, Mexico, India, and the United Kingdom). Employees pointed to a familiar set of obstacles to accessing care.

And while the overall group surveyed clearly identified their top barriers, the leading barriers are more nuanced when age, income, and other factors are considered.

What are the biggest barriers to mental health care?

When employees are asked what gets in the way of mental health support, the answers are strikingly practical.

Across Spring Health’s research, employees said the top barriers are:

• Lack of time: 43%
• Cost: 42%
• Work schedule and job demands: 30%
• Concerns about privacy: 30%
• Long wait times: 29%
• Stigma: 28%
• Lack of trust they'll get better: 25%

That matters because when support is hard to find, hard to trust, or hard to use, the benefit may exist on paper without making a real difference in people’s lives.

How income levels influence barriers to care

Income levels significantly influenced responses to top barriers to care. While Spring Health’s research was global, U.S. respondents were asked for their household income levels (within a range of options). Information about income-influenced barriers was compelling.

Among U.S. respondents, for lower-income employees, cost was the defining barrier. Slowly, as you moved to higher income brackets within the research, lack of time became the prevailing barrier.

• For those with household incomes of less than $75,000, cost was the top barrier at 53%. Lack of time was a distant second at 33%.
• For those with household incomes of at least $75,000 but less than $150,000, cost was at 46% and lack of time was at 45%.
• For those with household incomes of at least $150,000, lack of time emerges as the top barrier at 50%, followed by privacy concerns at 37% and cost at 34%.

Privacy concerns is another important nuance. Just 16% of employees with household incomes less than $25,000 cited privacy concerns, compared with 37% of those with household incomes of over $150,000.

That suggests that more senior or highly compensated employees may need something more than broad reassurance. They may need concrete proof that using mental health support is confidential, discreet, and safe.

Perceived access also tracks with income

Before employees can use a benefit, they have to know it exists.

Spring Health research also shows that awareness of employer-sponsored mental health benefits tracks strongly with income. Among employees with household incomes under $50,000, just 47% said their employer offers mental health benefits. Among employees with household incomes of at least $150,000, 80% said their employer offers mental or behavioral health benefits.

The report also found that 34% of employees say they are either not offered mental health benefits or are unsure whether they are, which indicates the possibility that many employees are simply unaware of the care available to them. For example, according to Mental Health America, 98% of mid-to-large U.S. companies offer an Employee Assistance Program (EAP).

For lower-income employees especially, the barrier may begin even earlier than cost or wait times. If the benefit is poorly explained, rarely mentioned, or buried in HR materials, access breaks down before care becomes a possibility.

Age influences barriers, too

Among global employees ages 18-34, the top barriers were:

• Lack of time: 52%
• Cost: 37%
• Availability due to job demands: 33%
• Privacy concerns: 32%

However, as populations within the survey got older, cost emerged as the top concern. But the percentage impacted by cost didn’t change much due to age; it’s simply that lack of time and availability declined as barriers.

Among employees 55 years of age and older, the top barriers were:

• Cost: 39%
• Privacy concerns: 26%
• Stigma: 26%
• Lack of time: 25%

Younger employees may face more time pressure at work, or feel less able to make time for care. Older employees may still face affordability challenges.

Barriers to care are practical, structural, and cumulative

Mental health equity requires recognizing that employees do not all start from the same place. There's a distinction between equality and equity. Equity means recognizing that barriers differ across circumstances and ensuring people receive support that reflects those realities.

For one employee, the barrier is cost. For another, it is the fear that seeking support will not stay private. For another, it is not being able to take a call during the workday. For another, it is long wait times for therapy. For another, it is not knowing whether the employer offers anything at all.

That is why removing barriers to mental health services has to go beyond awareness campaigns or one open enrollment mention per year. The support itself has to be easier to start.

What removing barriers to mental health care looks like

If employers want to improve access to mental health care, they need to design around the barriers employees actually face.

That includes:

• Employees should have a single point of entry for any mental healthcare. They shouldn't have to navigate a list of multiple phone numbers or determine on their own what specialist they really need.
• If cost is the leading barrier for lower-income populations, employers need to clearly articulate what support is available, what it costs, and what happens next to all employees. That might require different tactics for frontline populations versus those who work from a desk, for example.
• Getting them to the right care quickly is highly important. Fast access matters, but fast access to the wrong provider can become a barrier or reinforce existing barriers. If someone is matched to the first available appointment rather than a provider who can actually support their needs, they are less likely to stay engaged. Data-driven provider matching is vital.
• Employers also need to address privacy concerns around therapy explicitly. Employees should not have to guess what information is shared, what stays confidential, or whether using a mental health benefit could affect how they are perceived. Be clear about what you can and cannot see regarding mental health use.
• Employers should also acknowledge that time is not a side issue. Employees cannot access care that only works during business hours or assumes they have room in their day. Flexible scheduling, virtual options, and a simple path into support matter because convenience is often what determines whether care happens at all.

This story was produced by Spring Health and reviewed and distributed by Stacker.