Most people who need mental health care don’t access it. Here’s how to change that.

A recent study confirms something that’s rarely addressed in the design of benefits: Most people with a true mental health condition don’t seek care for it.

A recent study in JAMA Psychiatry confirms something that’s long been evident in the lives of caregivers—and rarely addressed in the design of benefits: most people with a true mental health condition don’t seek care for it.

Not because of stigma. Not because of cost or access. But because they don’t believe they need it.

According to the study, which had 56,927 respondents across 21 countries encompassing adults with a diagnosed mental disorder who weren’t receiving treatment, 46.5% reported “low perceived need” as the reason they were not receiving treatment. They didn’t think they needed help. This was far more common than concerns about cost, time, or even fear of judgment.

The implication is staggering: the mental health crisis is not just about access. It’s about relevance.

If we want to get more people the care they need, we have to meet them where they are—and for many working adults, that means meeting them in the context of caregiving.

The invisible mental health risk: caregiving adults

Caring for a child, partner, or aging parent takes a mental toll—yet caregivers are often the last to raise their hands for support. In Cleo’s own data, we consistently see caregivers put their own wellbeing on hold while they try to hold everything else together.

Caregivers don’t ignore their own health because they don’t care. They do it because they feel like they can’t. Time, energy, even identity—these are all wrapped up in someone else’s needs. So when a caregiver with clinical anxiety or depression says they don’t “need” help, it’s often because there’s no room to consider their own needs at all.

But that avoidance can become dangerous and costly, especially in the workplace. Left untreated, mental health conditions drive absenteeism, presenteeism, burnout, turnover, and increased medical claims.

The irony? Most employers already offer care navigation or therapy access. But it won’t matter if the person in need doesn’t believe it’s time to use it.

Helping them help their family is the way in

So how do we reach someone who doesn’t perceive their own need for care? We start by helping them do what they see as the priority: taking care of their family.

At Cleo, we’ve found that when you support a caregiver in the context of their family—whether it’s coaching them through a child’s learning challenges, coordinating elder care services for a parent, or navigating a spouse’s complex diagnosis—you earn trust. You show up for what matters to them. And that opens the door to a conversation about their health.

That’s where real mental health engagement begins. Not with a call to action, but with a call to care—about the people they love, and eventually, themselves.

 

It’s time to get realistic about mental health care

If we want to make a dent in mental health outcomes, it’s time to expand the strategy. Therapy apps and EAPs will always have a place—but they’re just one part of the picture. We need to account for the real human dynamics that stand in the way of care, especially for the caregivers holding it all together.

Caring for caregivers is more than a nice-to-have. It’s a smart, strategic way to reach the most disengaged members of your workforce—by starting with what they care about most.

 
Want to see how caregiving support can drive real mental health engagement? Let’s connect.