"His mom is dead, his dad was missing and presumed dead, he’s running around with a military organization... it’s not exactly conducive to therapy — and, of course, because it’s TV, therapists don’t exist."
— Connor Jessup, on his character Ben Mason from Falling Skies
In most fiction, there are no official systems in place to protect those who are psychologically vulnerable. Nobody is ever concerned that the kid who watched their parents die might be considering suicide, homicide, or fighting crimewithout due process. Fiction is full of Bunny-Ears Lawyers but this will be ignored so long as they're not crazy with axes.
This trope isn't saying the solution to every mental problem is to go to a head shrink; merely that there is an extreme amount of Genre Blindness regarding traumatic experiences, probably for the sake of convenience and drama. Remember, Fiction Is Not Fair in regards to characters.
Can be a Justified Trope, as you can hardly expect a rag-tag band of rebels in an oppressive dystopia to open up to a potential informant and a historical setting may predate therapy altogether. That being said, protesters in the Occupy movement have sometimes provided free healthcare systems which can include mental health care. Presumably a therapist must show some form of solidarity to be trusted.
May be an Enforced Trope out of a belief that fiction's more interesting that way, because the writers think poorly of psychiatry- or maybe because the characters belong to a culture which places the responsibility for an individual's mental state on their family and friends.
Sister Trope of Adults Are Useless
Dysfunction Junction: For stories (or works) where a main plot of the story is that those entire characters being cast are crazy.
The Shrink: If a character does go to a therapist but the therapist is unskilled, condemnatory, or otherwise problematic, see The Shrink; versions 1 and 2. If this trope is averted when the character goes to a good therapist and gets the help they need, see The Shrink; version 3.
Lampshaded in an episode in the English dub of Digimon Adventure 02. When Ken (who joined after a Heel Realization, having been the most insane villain they'd faced yet - yes, surpassing the Monster Clown) suggests that Wormmon talk to a therapist about his problems, Wormmon asks why he didn't talk to someone before becoming the Digimon Emperor?
Unintentionally Lampshaded in Rebuild of Evangelion when a character comments "those kids are our last hope, who knows what they're going through?", many Humongous Mecha series feature characters who clearly have flagrant psychological issues which are inexplicably overlooked so long as they are good pilots, which naturally never lasts for long. To make things worse, the EVAs only work if the pilots are horribly dysfunctional and emotionally messed-up. Even if there are a few therapists left, NERV wouldn't let them anywhere near the poor kids.
Comic Books
Parodied in What If v2 #2, where Daredevil murdered the Kingpin and went insane with guilt. While he's running around, he bumps into the Punisher. When he sees just how broken Daredevil's become, Castle actually recommends a psychiatrist and offers to take him there personally.
Sometimes I wonder whether it would be easier if I just had Shizuru see a psycologist. The problem being, how does she say "I have a huge guilt complex over killing scores of people with my summoned demon named after the legendary Kiyohime" without being put in an asylum? Perhaps the First District has specilised psycologists. Oh, wait. She blew them up. That's what she's guilty about.
Literature
Played with in every way in Bujold's Vorkosigan Saga. The main character is from Barrayar, a feudal militaristic culture where one is expected to go through hell and get over it without complaints and definitelywithout therapy, but his mother is from Beta Colony, a high-tech hyper-sophisticated and modern world where all is well-regulated and therapy is the normal response to any trauma or psychological issue. The trope is inverted in the first book for both worlds: Cordelia's awesome Betan therapists refuse to believe she is actually sane and wasn't brainwashed into falling in love with the enemy and she ends up having to run away, while it's revealed that Barrayaran therapy of the kind Bothari went through is possibly worsethan the original trauma. In later books the trope is played straight (and Lampshaded by Cordelia repeatedly), especially where Barrayar is concerned. But it is thankfully averted for Mark after a book or two, because he reallyREALLYneeds it.
Live Action TV
Some police procedural and military themed series try to avert this trope with special episodes focused on the main characters being forced to attend mandatory counseling sessions to determine whether they are fit for duty.
Heavily averted in My Mad Fat Diary. Kester is an extremely good therapist to Rae, and appears to be better than her previous one.
Chloe is also offered therapy following her abortion.
Music
Quadrophenia features the overlap with Adults Are Useless. Jimmy asks a therapist, vicar, and his mother in the very second song, but it doesn't do any good.
Video Games
This trope is literal in Furcadia as psychology has not been invented yet and magic generally only heals the body and not the mind. Several of the gods in this setting are also insane (oh, and like to wander among the mortals...).
Deconstructed in Blaze Union. We learn very early on that its Broken Hero, Gulcasa, has a lot of serious issues due to having been abused and abandoned by his parents, and he's only able to function because his childhood friends (who are also pretty much his adoptive parents) are there to act as amateur counselors for him. During the canon route of the game, Siskier dies, and this is really only just the start. Gulcasa blames himself for everything, and winds up with a raging case of PTSD which makes him so terrified of failure that he stops hesitating altogether and starts acting much more stoically. His remaining childhood friend and mentor mistake his symptoms for Gulcasa losing his humanity, as it was conveniently revealed that he's part demon. And they try to kill him, leaving Gulcasa a complete psychological wreck. The only people who even bother to try to help him have their own agendas, not to mention their own festering cesspools of mental-emotional trauma. In all likelihood, things wouldn't have gone quite so badly for Gulcasa and company three years later if someone had just gotten the poor kid a competent grief counselor.
Pariodied in Alpha Protocol if Mike is played as a brutal, violent Jerkass to Madison. She'll ask him if he has ever sought professional help. He replies that he hasn't, because he killed all his therapists.
Web Comics
In Something Positive there are many cases of this, sometimes lampshaded, but the one that stuck out most for me is when Davan never gets help after being raped by a woman he was attracted to. Sadly this is probably Truth in Television for many rape victims, especially male ones, and especially when the rapist is a woman.
Played with in Homestuck. There are no therapists, but there are plenty of amateurs, Rose and Karkat in particular love to psychoanalyze the other characters, and Karkat even gives out relationship advice for the other Trolls.
Mild subversion in Karkat's case in that Karkat is a film buff like John, only where John is into cheesy monster flicks, Karkat prefers romantic comedies-and his species defines four different relationships as forms of romance. So all his relationship advice is coming from his movie-watching habits rather than his tendency to psychoanalyze, and is thus dubious at best.
Played with in Spacetrawler. The I.A. Starbanger does have a Therapy-bot, but he's terrible: his therapy consists solely of telling patients that their feelings are irrational. Eventually, Martina realizes that one of her crew desperately needs treatment for post-traumatic stress disorder, so she replaces Therapy-bot with a qualified therapist.
Played with in FreakAngels comics. Sirkka is the local equivalent of a psychologist and helps abuse victims and people mind raped by Mark. Her own love life, on the other hand, is a total mess. Other Freakangels are not much better with the group consisting of The Ophelia, an Ineffectual Loner, a Knight Templar, a guy driven crazy by his own guilt, A God Am I wannabe and a few other dysfunctional personality types. Some hide it better than others. At the end they all get a quick therapy from Arkady of all people and Luke is fixed on his own request. Even Mark seems to be much more sane. It is implied that their problems didn’t magically disappear, but they will eventually get over their issues with some love and hard work. FreakAngels are True Companions after all.
Zig-zagged in A Loonatic's Tale. There are, in fact, therapists, they're even major characters in the comic, but they have a whole host of psychological issues all their own which may or may not prevent them from actually doing their patients any good (at least one is too apathetic to do his job, so he just medicates them into oblivion). On top of that, most of them reckon that, since they're therapists, they're immune to psychological disorders, and wouldn't need help even if they weren't.
Web Original
The Nostalgia Critic used to mention going to a therapist a lot, but that stopped, probably because the character was getting more and more damaged and it was funnier that way.
In fact, a running gag among multiple reviewers is their constant danger of insanity due to the bad things they are "forced" to experience. Plenty of reviews have gags where the reviewer pops "happy pills" like they were candy, chugs from a bottle of booze, or is forcibly restrained by men in white coats. Some have even tried to destroy the world in a bout of rage.
Played with in Winx Club: The Trix are sent to a place where they are supposed to be reformed, but it only manages to tick them off even more.
Lampshaded in As Told by Ginger in an episode where Ginger becomes jealous of Darren's new relationship with Miranda. Of course she didn't technically see a psychologist.
Ginger: "It's just that Dr Phonsfeelings said—"
Darren: "Whoa, you went to see a therapist?"
Ginger: "Not exactly. She was on Channel 9"
Said TV psychologist appears in another episode and causes more problems when Ginger starts freaking out that her mother is still single.
And inverted in another episode where Ginger is sent to the school psychologist because she writes a poem about a girl who wishes to disappear. Everyone assumes Ginger has suicidal intentions because of this but she's actually fine.
Zig-zagged in Young Justice. Black Canary is a trained therapist, and is shown having sessions with the teens after seriously traumatizing events. For some reason, no one seems to give the same consideration to Arsenal, who is suffering from serious issues that have interfered with their missions more than once.
Zig-zagged in Adventure Time. Ooo is a very strange place with a lot of even stranger people, but there actually are mental health services for those who need them. For a lot of the earlier episodes, however, this trope was played straight, with people such as Lemongrab and Ice King basically just being dealt with when they caused trouble and ignored when they didn't. Both of them have now been getting a lot more help.
