Answer:
1) Most people with anxiety or depression are often too afraid to seek help, because they are afraid to be judged and or too scared to openly ask for help when they need it.
2) An external factor would be expectations of friends, in our society people are often more scared to be open about their feelings or seeking help.
3) Some changes would be, getting people more personal counselling. Or making appointments to see their family doctor to seek help if they're too afraid to seek help from (example,) friends, family, teachers, grandparents.
Explanation:
sorry if my answer doesn't answer your questions, as a person who suffers from anxiety and depression these are the most simple ways i could explain. :D
