Breaking the Stigma: How Counseling is Changing Conversations About Mental Health

April 22, 2025


In a world where approximately one in five adults experiences mental illness each year, only 46% of those individuals seek treatment, according to the National Institute of Mental Health (NIMH, 2023). For decades, the gap between need and care has been bridged by silence—silence fueled by stigma, misunderstanding, and fear. This fear and misunderstanding is highlighted by recent inaccurate information by Health and Human Services Secretary Robert F. Kennedy Jr. regarding Autism. Yet today despite the continued spread of misinformation, we find ourselves at a pivotal moment in history, where the conversations around mental health and counseling have been transforming.

National Counseling Awareness Month offers an opportunity to examine how far we've come in breaking down these barriers and how we are reshaping public discourse around seeking help. This transformation isn't happening by accident—it's the result of deliberate efforts across multiple fronts to normalize counseling as an essential component of holistic healthcare.

The Evolution of Mental Health Conversations

The story of mental health stigma stretches back centuries, with treatments often being more harmful than helpful and those suffering frequently hidden away from society. Even in the latter half of the 20th century, seeking therapy was often done quietly, with appointments scheduled discreetly and discussions about mental health challenges limited to whispers.

This shift didn't happen overnight. Key turning points include the passage of mental health parity laws, increasing representation in media, and gradual cultural acceptance that mental health deserves the same attention as physical health. Recent surveys indicate that 87% of Americans now acknowledge that having a mental health disorder is nothing to be ashamed of—a marked improvement from just a decade ago, according to data from the American Psychological Association's Stress in America survey (APA, 2024).

Factors Driving Positive Change

Celebrity and Public Figure Advocacy

When Prince Harry opened up about seeking therapy to process grief, or when Michael Phelps shared his struggles with depression despite Olympic success, these revelations carried tremendous weight. Celebrities and public figures who speak candidly about their counseling experiences help dismantle the notion that therapy is only for certain people or that seeking help indicates weakness.

Olympic gymnast Simone Biles made headlines when she withdrew from several events at the Tokyo Olympics to prioritize her mental health. Her decision to be transparent about needing mental health support while competing at the highest level sparked global conversations about the psychological pressures athletes face. In subsequent interviews, Biles openly discussed the importance of her therapy sessions in managing anxiety and the "twisties"—a dangerous mental block gymnasts can experience.

In another compelling example from the sports world, professional soccer player Bethany Balcer of Racing Louisville has used her platform to normalize mental health treatment. Balcer has openly shared her experiences with anxiety and depression on social media, documenting her therapy journey and how counseling has helped her both on and off the field. Her candid posts about therapy appointments and mental health practices have resonated particularly with young female athletes who previously felt pressure to project constant strength and positivity.

The impact is quantifiable: according to research published in the Journal of Counseling Psychology (Thompson et al., 2024), one study found that 35% of new therapy clients cited a public figure's disclosure as influencing their decision to seek help.

Media Representation Shifts

Gone are the days when therapists in film and television were predominantly portrayed as eccentric, ineffective, or exploitative. Shows like "Ted Lasso," "This Is Us," and "In Treatment" have presented nuanced, realistic depictions of the counseling process.

Social media platforms have further accelerated this normalization. Hashtags like #TherapyWorks and #MentalHealthMatters connect millions of users sharing their experiences. A 2024 report from the Pew Research Center found that 62% of adults have encountered mental health content on social media platforms, with 41% reporting that such content made them more likely to consider seeking professional help. Mental health professionals have also established informative presences on these platforms, making psychological concepts more accessible to the general public.

Workplace Wellness Revolution

Corporate America has undergone its own transformation regarding mental health support. What was once limited to traditional Employee Assistance Programs has expanded to comprehensive wellness initiatives that explicitly include counseling services.

Major companies like Microsoft, Starbucks, and PwC have not only expanded mental health benefits but actively encourage utilization through company-wide mental health days, leadership training on recognizing emotional distress, and internal campaigns to reduce stigma. According to the Society for Human Resource Management's 2024 Employee Benefits Survey, 91% of employers now offer some form of mental health support, up from 75% in 2019.

Educational Outreach Initiatives

The counseling profession itself has taken proactive steps to educate communities about the value and process of therapy. Organizations like the American Counseling Association have developed public awareness campaigns, while individual practitioners frequently volunteer their expertise at community events.

School counseling programs have expanded beyond academic guidance to incorporate mental wellness education. The American School Counselor Association (ASCA, 2023) reports that 78% of K-12 schools now include mental health awareness in their curriculum—a dramatic increase from 45% a decade ago. Students today are learning emotional regulation strategies and the importance of seeking help when needed—knowledge they bring home to their families.

Innovative Approaches in Modern Counseling

The counseling field hasn't just benefited from changing perceptions—it has actively evolved to meet people where they are, further reducing barriers to entry.

Telehealth services exploded during the COVID-19 pandemic and have remained popular, allowing people to access counseling from the privacy of their homes. According to the Centers for Medicare & Medicaid Services (2024), telehealth mental health visits increased by 3,200% in 2020 compared to 2019 and have maintained approximately 40% of all mental health services into 2024. This option has proven particularly valuable for those in rural areas, people with mobility limitations, or individuals with busy schedules.

Evidenced based practices are also enhancing the quality of care that is provided to individuals. According to the American Counseling Association (ACA) "Evidence-based practice is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences. It involves systematically locating, appraising, and using contemporaneous research findings as the basis for clinical decisions." These approaches may involve therapeutic modalities life Cognitive Behavioral Therapy (CBT) or may be more specific and targeted treatment approaches like EMDR or TF-CBT. 

Culturally responsive counseling approaches have expanded, with increased training for practitioners to understand diverse backgrounds and experiences. This evolution acknowledges that mental health concepts aren't universal across cultures and that effective counseling must respect individual contexts.

The integration of counseling with primary healthcare represents another significant advancement. When primary care physicians include mental health screenings and make direct referrals to counselors—sometimes located within the same facility—it removes the burden of seeking separate care and frames mental health as an integral component of overall wellness. The Collaborative Care Model, endorsed by both the American Psychiatric Association and the American Academy of Family Physicians, has shown a 50% improvement in treatment outcomes compared to care as usual, according to research published in JAMA Psychiatry (Williams et al., 2023).

Persistent Challenges

Despite remarkable progress, significant obstacles remain:

Cultural variations in stigma persist, with some communities still viewing mental health challenges as character flaws or spiritual failures rather than health conditions requiring professional support. According to the National Alliance on Mental Illness (NAMI, 2024), stigma is particularly pronounced in certain minority communities, with research showing that Black Americans utilize mental health services at about half the rate of white Americans, and Latino and Asian Americans at even lower rates.

Financial barriers continue to limit access, with insurance coverage for mental health services often inadequate despite parity laws. The 2024 State of Mental Health in America Report found that 1 in 4 adults of adults with mental health needs reported unmet needs due to costs.

Rural communities face particular challenges, with fewer providers available and concerns about confidentiality in small towns where "everyone knows everyone." Data from the Health Resources & Services Administration (HRSA, 2023) indicates that more than 150 million Americans live in designated Mental Health Professional Shortage Areas. Men continue to utilize counseling at lower rates than women, influenced by traditional masculine norms that equate seeking help with weakness.

Strategies for Continued Progress

To build on current momentum, counseling advocates recommend:

Looking Forward

As we observe National Counseling Awareness Month, there's much to celebrate in how far the conversation around mental health has evolved. Yet the work continues, with counselors at the forefront of efforts to create a world where seeking mental health support carries no more stigma than getting treatment for any other health condition.

For those considering counseling but still hesitant due to lingering stigma, remember: seeking help is not a sign of weakness but of courage—a decision to prioritize well-being that millions have made before you, with life-changing results.


SIDEBAR: MYTHS VS. FACTS ABOUT COUNSELING

MYTH: Counseling is only for people with severe mental illness.
FACT: Counseling benefits people across the spectrum of experiences, from those managing everyday stress to those with diagnosed conditions.

MYTH: Going to counseling means something is "wrong with you."
FACT: Counseling is about growth and developing healthy coping skills—strengths that benefit everyone.

MYTH: Counseling requires talking about your childhood for years.
FACT: Modern approaches often focus on present challenges and solutions, with many evidence-based treatments showing results in just 8-12 sessions.

MYTH: A good friend is just as helpful as a counselor.
FACT: While social support is vital, counselors provide unbiased perspective and specialized techniques based on scientific research.

MYTH: Seeking counseling will be noted in permanent records and could affect employment.
FACT: Counseling records are protected by strict confidentiality laws, with limited exceptions for imminent safety concerns.


RESOURCES

Finding a Counselor:

Crisis Support:


REFERENCES

American Counseling Association (2024). Journal of Counseling & Development Special Issue: Evidence-Based Practices in Counseling, Vol. 102, p. 15-27.

American Psychiatric Association & American Academy of Family Physicians. (2023). The Collaborative Care Model: Evidence-based approach to integrating physical and behavioral health care.

American Psychological Association (APA). (2024). Stress in America survey.

American School Counselor Association (ASCA). (2023). The school counselor's role in mental health.

Centers for Medicare & Medicaid Services. (2024). Telehealth trends report.

Health Resources & Services Administration (HRSA). (2023). Mental Health Professional Shortage Areas.

Mental Health America. (2024). Access to care report.

National Alliance on Mental Illness (NAMI). (2024). Mental health by the numbers.

National Institute of Mental Health (NIMH). (2023). Mental illness statistics.

Pew Research Center. (2024). Social media and mental health awareness.

Society for Human Resource Management. (2024). Employee benefits survey.

Thompson, R., et al. (2024). Impact of celebrity mental health disclosures on help-seeking behavior. Journal of Counseling Psychology.

Williams, J., et al. (2023). Implementation of the collaborative care model. JAMA Psychiatry.

Acknowledgement

This article on 'Breaking the Stigma: How Counseling is Changing Conversations About Mental Health' was developed with the assistance of Claude, an AI assistant created by Anthropic. The foundational research, framework, and concept development were conducted in collaboration with Claude in April 2025. Editing, additional background, final review and fact-checking was completed by Stephen Klump.


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