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Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies

Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies
Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies
Mental health disorders in children and adolescents are highly prevalent yet undertreated. A detailed understanding of the reasons for not seeking or accessing help as perceived by young people is crucial to address this gap. We conducted a systematic review (PROSPERO 42018088591) of quantitative and qualitative studies reporting barriers and facilitators to children and adolescents seeking and accessing professional help for mental health problems. We identified 53 eligible studies; 22 provided quantitative data, 30 provided qualitative data, and one provided both. Four main barrier/facilitator themes were identified. Almost all studies (96%) reported barriers related to young people’s individual factors, such as limited mental health knowledge and broader perceptions of help-seeking. The second most commonly (92%) reported theme related to social factors, for example, perceived social stigma and embarrassment. The third theme captured young people’s perceptions of the
therapeutic relationship with professionals (68%) including perceived confidentiality and the ability to trust an unknown person. The fourth theme related to systemic and structural barriers and facilitators (58%), such as financial costs associated with mental health services, logistical barriers, and the availability of professional help. The findings highlight the complex array of internal and external factors that determine whether young people seek and access help for mental health difficulties. In addition to making effective support more available, targeted evidence-based interventions are required to reduce perceived public stigma and improve young people’s knowledge of mental health problems and available support, including what to expect from professionals and services.
Adolescents, Barriers, Children, Facilitators, Mental health, Professional help
1018-8827
1-29
Radez, Jerica
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Reardon, Tessa
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Creswell, Cathy
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Lawrence, Peter
0d45e107-38ef-4932-aec1-504573de01ef
Evdoka-Burton, Georgina
5edce593-9f07-46bb-a91c-cc4cae4e13ad
Waite, Polly
a4b1d85d-89a3-434f-95dd-384bcd667d95
Radez, Jerica
151194ba-16cb-4ca8-b69a-f30a5e4ee3d6
Reardon, Tessa
8de9ae4e-9626-449b-b736-43f80bfe3f96
Creswell, Cathy
a4dc4d1f-007d-48b5-9ddf-2d24da87b489
Lawrence, Peter
0d45e107-38ef-4932-aec1-504573de01ef
Evdoka-Burton, Georgina
5edce593-9f07-46bb-a91c-cc4cae4e13ad
Waite, Polly
a4b1d85d-89a3-434f-95dd-384bcd667d95

Radez, Jerica, Reardon, Tessa, Creswell, Cathy, Lawrence, Peter, Evdoka-Burton, Georgina and Waite, Polly (2020) Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. European Child & Adolescent Psychiatry, 1-29. (doi:10.1007/s00787-019-01469-4).

Record type: Article

Abstract

Mental health disorders in children and adolescents are highly prevalent yet undertreated. A detailed understanding of the reasons for not seeking or accessing help as perceived by young people is crucial to address this gap. We conducted a systematic review (PROSPERO 42018088591) of quantitative and qualitative studies reporting barriers and facilitators to children and adolescents seeking and accessing professional help for mental health problems. We identified 53 eligible studies; 22 provided quantitative data, 30 provided qualitative data, and one provided both. Four main barrier/facilitator themes were identified. Almost all studies (96%) reported barriers related to young people’s individual factors, such as limited mental health knowledge and broader perceptions of help-seeking. The second most commonly (92%) reported theme related to social factors, for example, perceived social stigma and embarrassment. The third theme captured young people’s perceptions of the
therapeutic relationship with professionals (68%) including perceived confidentiality and the ability to trust an unknown person. The fourth theme related to systemic and structural barriers and facilitators (58%), such as financial costs associated with mental health services, logistical barriers, and the availability of professional help. The findings highlight the complex array of internal and external factors that determine whether young people seek and access help for mental health difficulties. In addition to making effective support more available, targeted evidence-based interventions are required to reduce perceived public stigma and improve young people’s knowledge of mental health problems and available support, including what to expect from professionals and services.

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Accepted/In Press date: 31 December 2019
e-pub ahead of print date: 21 January 2020
Additional Information: Funding Information: JR is funded by the University of Reading through an Anniversary PhD Scholarship. CC, PJL and TR are funded by an NIHR Research Professorship awarded to CC (NIHR-RP-2014-04-018). PW is supported by an NIHR Post-Doctoral Fellowship (PDF-2016-09-092). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. The authors thank Caitlin Thompson, BSc student of University of Reading, for help with abstract and full-text screening, and Dr Cyra Neave from the Anna Freud Centre for insight into practical aspects of school-based mental health interventions. The research materials can be accessed by contacting the corresponding author. Publisher Copyright: © 2020, The Author(s).
Keywords: Adolescents, Barriers, Children, Facilitators, Mental health, Professional help

Identifiers

Local EPrints ID: 437629
URI: http://eprints.soton.ac.uk/id/eprint/437629
ISSN: 1018-8827
PURE UUID: 31fbee43-28b2-49cd-b8aa-a91f15c2522d
ORCID for Peter Lawrence: ORCID iD orcid.org/0000-0001-6181-433X

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Date deposited: 07 Feb 2020 17:30
Last modified: 17 Mar 2024 03:34

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Contributors

Author: Jerica Radez
Author: Tessa Reardon
Author: Cathy Creswell
Author: Peter Lawrence ORCID iD
Author: Georgina Evdoka-Burton
Author: Polly Waite

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