Access to mental health and addiction services for youth and their families in Ontario: perspectives of parents, youth, and service providers

Abstract

Background Canadian youth (aged 16–24) have the highest rates of mental health and addiction concerns across all age groups and the most unmet health care needs. There are many structural barriers that contribute to the unmet mental health care needs of youth including lack of available and appropriate services, high costs, long wait times, fragmented and siloed services, lack of smooth transition between child and adult services, stigma, racism, and discrimination, as well as lack of culturally appropriate treatments. Levesque et al. (2013) developed a framework to better understand health care access and this framework conceptualizes accessibility across five dimensions: (1) approachability, (2) availability, (3) affordability, (4) appropriateness, and (5) acceptability. The purpose of this study was to explore access to addiction and mental health services for youth in Ontario, Canada from the perspectives of youth, parents, and service providers. Methods This qualitative study was a university-community partnership exploring the experiences of youth with mental health concerns and their families from the perspectives of youth, caregivers, and service providers. We conducted semi-structured interviews and used thematic analysis to analyze data. Results The study involved 25 participants (n = 11 parents, n = 4 youth, n = 10 service providers). We identified six themes related to structural barriers impacting access to youth mental health and services: (1) “The biggest barrier in accessing mental health support is where to look,” (2) “There’s always going to be a waitlist,” (3) “I have to have money to be healthy,” (4) “They weren’t really listening to my issues,” (5) “Having more of a welcoming and inclusive system,” and (6) “Health laws aren’t doing what they need to do.” Conclusion Our study identified five structural barriers that map onto the Levesque et al. healthcare access conceptual framework and a sixth structural barrier that is not adequately captured by this model which focuses on policies, procedures, and laws. The findings have implications for policies and service provisions, and underline the urgent need for a mental health strategy that will increase access to care, improve mental health in youth, decrease burden on parents, and reduce inequities in mental health policies and services.

Exploring stakeholders’ perceived problems associated with the care and support of children and youth with mental ill health in Sweden: a qualitative study

“…The perceived problems identified in this study are similar to findings in previous studies [ 17 , 18 , 20 , 27 ]; for example, the subcategories Need to fight to get help [ 20 , 27 ], Lack of co-ordination and lack of consensus between organizations [ 17 , 18 , 20 ] and Lack of knowledge about where to seek help [ 17 , 18 , 20 , 27 ]. Using corresponding concepts, the findings from other studies have been discussed as barriers related to either collaboration or assessing care and support for children and youth with mental ill health.…”

Perceptions of mental health providers of the barriers and facilitators of using and engaging youth in digital mental-health-enabled measurement based care

“… 9 , 10 The high prevalence of mental health disorders among youth is accompanied by a considerable treatment gap, 11 and even those who manage to access services often receive limited evidence-based treatment. 12 Access to mental health services for youth is hindered by various barriers, including limited availability, 13 , 14 lack of culturally responsive treatments, 14 , 15 high costs, 15 , 16 long wait times, 14 , 17 , 18 geographical challenges, 15 fragmented and siloed care, 18 – 21 as well as pervasive stigma and discrimination. 15 , 16 , 18 , 22 These barriers contribute to delays in accessing care and perpetuate inequalities, particularly among marginalized groups, including Black, Indigenous, and People of Color (BIPOC), 15 , 23 , 24 as well as gender diverse populations.…”

Transcending technology boundaries and maintaining sense of community in virtual mental health peer support: a qualitative study with service providers and users

“…Peer support can promote empowerment and self-efficacy, help enhance coping skills and strategies, and contribute to overall quality of life and emotional well-being [ 4 – 6 ]. It has been particularly helpful in situations where traditional professional mental health services might not fully address the needs of individuals or are not easily accessible [ 3 , 7 ].…”