Someone elsewhere in the thread pointed out that it's truly hard to open up to another human, especially face to face. Even if you know they're a professional, it's awkward, it can be embarrassing, and there's stigma about a lot of things people ideally go to therapy for.
I mean, hell, there's people out there with absolutely terrible dental health who are avoiding going to the dentist because they're ashamed of it, even though logically, dentists have absolutely seen worse, and they're not there to judge, they're just there to help fix the problem.
https://en.wikipedia.org/wiki/Suicide_and_Crisis_Lifeline