Good Question: How do I know if it’s the right time to seek mental health counselling?

January 15, 2026 | 3 min read

The number of Canadians living with depression and anxiety has risen sharply over the past decade,¹ and more people are reporting that stress, burnout, and emotional exhaustion are affecting their ability to show up fully in their jobs and personal lives.²

According to Manulife claims data, in 2024 the number of people making mental health claims increased by 10.2% from the previous year.³ However, less than half of Canadians with access to mental health coverage through extended health benefits at work take advantage of these resources,⁴ which can range from educational material, Employee and Family Assistance Programs (EFAPs) to virtual counselling to in-person visits with a professional. 

This could be due to several factors, says Dr. Nadia Aleem, a psychiatrist at Cleveland Clinic Canada (which is Manulife’s medical director for group benefits). Cost, stigma, and finding time are three common obstacles people can face when trying to access care. But another major barrier is the belief that mental health care should only be accessed during times of illness and/or crisis. Dr. Aleem offers a different perspective: thinking of mental health care as preventive, like a dental cleaning or annual physical checkup.

According to Manulife Canada research, the top motivator for initiating mental health services, especially among first-timers, is feeling emotionally ready. Here, Dr. Aleem explains why “ready” doesn’t have to be defined as a “feeling” -- it can be a decision.

Dr. Aleem: There’s a misconception that you should only seek mental health support when you are emotionally distressed, your functioning has started to deteriorate, and you are unwell. And there is stigma attached to that: Going to therapy must mean there is something wrong with you, that you have an illness.

Another reason is that access to mental health care services used to be more limited. Until recently, employers tended not to invest in these benefits, so people aren’t in the habit of knowing that they’re available to them. This is why it’s important that organizations continue to educate employees about what’s available.

Finally, many people have outdated ideas about therapy. They might imagine therapy as a passive process where an individual is analyzed and evaluated by a clinician. But modern therapy and other mental health supports aren’t about being “fixed.” They're about gaining tools, insight, and strategies that help you feel and function better.

Dr Aleem: One of the first signs to watch for is changes in sleep. Are you having trouble getting to or staying asleep or are you sleeping too much? You might also notice yourself relying on coping behaviors that don’t serve you, like higher alcohol use, overeating, binge-watching TV, or excessive scrolling. Ask yourself: If you’re scrolling for hours a week, what are you avoiding emotionally? Left unchecked, these symptoms can lead to overwhelm, irritability, and an inability to meet daily demands.

If you have access to an EFAP (Employee and Family Assistance Program) through your group benefits, this might be a good time to engage in some preventive care before symptoms become severe. Too often, people wait until they’re struggling and then turn to EFAPs, which are more suited for short-term care and/or prevention. The more proactively you use EFAPs, the more beneficial they are. 

Dr. Aleem: Know that you’re in the driver’s seat. Go into it with a mindset of feeling empowered to learn and to advocate for your mental health. You are not there to be analyzed or judged. Therapy is not passive; it’s collaborative.

It helps to come in with a goal: What do you want to work on? Some of the most positive sessions I’ve had with clients start with a clear statement like: “I want to improve my sleep” or “I want to communicate better with my partner.”

And don't hesitate to bring your concerns, even if they feel silly. For example, it’s okay to ask things like: “Will you judge me?” or “Will you share this with my employer?” Naming these worries upfront helps build trust and put you at ease.

Dr. Aleem: First, the counsellor will ask what brought you in and what you’d like to achieve. They’ll discuss scheduling and fees and invite any questions about treatment that you may have. You will also be asked to review and sign consent and privacy forms, which go over things like confidentiality and boundaries.

Depending on your goals, the next session will likely involve gathering a detailed background from you. Your counsellor will ask questions about your lifestyle, health history, relationships, and work in order to get to know you. This shouldn’t take more than one or two sessions. By session three or four, you should start learning practical tools and strategies—something actionable you can apply between appointments.

Dr. Aleem: A counsellor’s specialty or specific credentials often matter less than whether you feel understood. It’s important that you feel like they get you and you can be open with them. Some people prefer a counsellor they identify with culturally, by sexual orientation, or by gender—it can provide comfort knowing that you share similar lived experiences. For others, they don’t feel it’s necessary; it’s very much up to the individual. 

Dr. Aleem: Connection can be built virtually or in person, and research⁵ shows both formats are effective, so choose what suits your lifestyle. Many working individuals prefer virtual because you can more easily fit sessions into your day.

Dr. Aleem: In terms of modality, I’d say fit can matter more. Many therapists will incorporate multiple modalities, like cognitive behavioural therapy (CBT), mindfulness-based cognitive therapy (MBCT), and emotion-focused therapy (EFT), taking bits and pieces from each and tailoring their approach to suit your needs.

Dr. Aleem: First sessions can feel awkward—it’s like meeting anyone new—so try not to judge fit right away. But you should have a sense if it’s working after three sessions. If you don’t feel aligned or that your counselling is helping by then, you can talk to your therapist about it and give them a chance to redirect their approach.

If you’d rather not have that conversation, you can simply change counsellors. A professional therapist will understand and support that decision. And most benefits programs and EFAPs make it easy to select a new provider.

When booking your next therapist, make sure to tell them what didn’t work with your last one. And be specific about what you are looking for, so you can find alignment and keep building the tools to stay balanced and well.

This article is for informational purposes only. It is not intended to diagnose or treat a condition. If you have questions or concerns about your specific situation or are seeking medical advice, contact your medical doctor or your health-care provider.

Cleveland Clinic Canada

Manulife is proud to have Cleveland Clinic Canada on board as Medical Director for our Group Benefits operations. Cleveland Clinic Canada has a wealth of global healthcare expertise and shares our goal to help Canadians live longer, healthier, and better lives. Cleveland Clinic is a nonprofit organization that has been at the forefront of modern medicine since 1921. In recent years, Cleveland Clinic has worked with progressive companies in Canada and around the world to prioritize the health and well-being of their employees, customers, and communities.