There are hundreds of millions of people worldwide with mental health conditions. And according to the World Health Organization, most of them will never get care.

Whether or not you have insurance, there are plenty of barriers in place that keep people who need help from getting it.

In the latest Carolina Curious, WFDD's Sean Bueter finds out more about those challenges, and how to overcome them.

In a suburban home just outside Greensboro, Ulli Becker lives with a lot of roommates: a small pack of cats – each with its own personality, of course – and a room full of colorful birds.

“Two Quakers, then three cockatiels, and I'm actually on my third generation of cockatiel,” she says proudly.

By most measures, Becker's successful – a Ph.D., a decades-long career in science, and her own home. She's now spent half her life in the United States. But she also lives with mental illness, specifically depression and PTSD. In the early 2000s, things broke bad.

“In my job, I was supposed to be giving a presentation – reasonably prestigious – and I was having fantasies of killing myself on stage,” she says.

To state the obvious, this is troublesome and uncommon. For her part, Becker doesn't even know where she'd get a gun.

And yet, this fantasy persisted. But she was fortunate. She had resources, good insurance, and the ability to take time off. But it took a while to get those wheels turning.

“So I was probably on the lucky end of actually having somebody and having the company support that,” she says.

Andy Hagler with the Mental Health Association in Forsyth County might agree.

After all, Becker knew what to do, and where to go. She had the information and support she needed to get help.

But plenty of people don't even know where to start, even if they're insured.

“For a lot of people, especially if they do have private health insurance, it's as easy as looking at the back of your insurance card,” Hagler says.

Depending on your plan, the first step toward help could be right in your wallet. On that card, there should be a number to call to get set up with mental health care.

Still, if you're in crisis, that may not help you much. And sometimes, timely appointments can seem impossible to get.

“It could be fairly soon. But it could be six weeks, it could be eight weeks, or, well…first appointment's going to be [months from now].”

And all of that is if you have insurance. Knowing how to access the system is one thing. Waiting it out can present a whole new set of problems.

But what if you're low-income and uninsured?

“There are absolutely barriers – in terms of socio-economic barriers that prevent people from just getting through the front door of where a therapist or program like ours could be.”

Jodi Lorenzo-Schibley heads a nonprofit called Sanctuary House in Greensboro that runs support programs for adults with mental illness.

She says it's not just awareness and long wait times that face low-income people. You may not have a car. You might have to take off a vital work day. You may have to dig deeper financially to get the care you need. And, she says, this particular population has grown.

“North Carolina did not choose to expand Medicaid, so by virtue of that, we have an increasing population of uninsured individuals,” she says.

There are programs in the Triad that offer free or sliding-scale services. The thing is, all these issues we've been talking about are part of our infrastructure and tough to change.

But, no matter who you are, or what your coverage status is, probably the biggest roadblock to care is stigma.

Multiple studies have shown that stigma and embarrassment about mental health keep people who need it from seeking it out.

And everyone we talked to – including Ulli Becker – wants to see that change.

“A lot of people, I think, feel shame, they feel the stigma. So, somebody may easily come out and say, ‘Oh see here, I have this bump, I think I may have poison ivy,'” Becker says. “Nobody goes around and says, ‘you know, I'm feeling low, I think I have depression.'”

Becker is now about a year removed from her last run of bad days. Things are good. She's working hard and has her furry friends. She's even taken up the ukulele, though admits she needs some practice.

“Of course, I also don't know a lot of these songs!" she laughs.

But she does hope sharing her story will encourage others to persist and get help.

If you need help, consider reaching out:

National Suicide Prevention Hotline: 1-800-273-8255​

Mental Health Association In Forsyth County: (336) 768-3880

Mental Health Association In Greensboro: (336) 373-1402

If insured, call the number listed on your insurance card. And if you're in crisis and need help immediately, consider calling 911.

 

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