Help-seeking experiences and barriers to mental health support for adolescents experiencing mental ill-health and social exclusion

Abstract

Background: Adolescence is a critical period for mental health; a significant portion of mental health disorders emerge during this time. Social exclusion represents the absence of opportunities for full participation in society and is a key determinant of mental health. This study aimed to better understand the help-seeking experiences of young people facing co-occurring social exclusion and mental ill-health focusing on where young people sought support, barriers they had experienced in seeking such support, and their preferences for mental health supports.Methods. Data from the 2022 Mission Australia Youth Survey (N=18,800) were analysed, from a subset of 9,743 young people aged 15-19 who reported having needed mental health support. Self-response to questions regarding four domains of social exclusion (housing, finances, relational, education/employment), demographic characteristics, psychological distress and help-seeking behaviours (perceived need, mental health supports, barriers to access, preferences) were included. Relationships between social exclusion domains, mental health concerns and help-seeking behaviours (access, barriers and preferences) were explored using logistic regression models controlling for demographic factors and psychological distress.Results. Only 58.1% of participants reported having sought mental health support (n=5,565). Social exclusion domains were associated with different help-seeking behaviours. Housing challenges were associated with higher help-seeking (OR:1.28; 95%CI: 1.15-1.42); relational difficulties and edu-employment issues with lower (OR:0.75; 95%CI: 0.68, 0.83 and OR:0.82; 95%CI: 0.75, 0.89). Stigma, confidentiality concerns, cost, and not knowing where to seek help were common barriers to help-seeking, with those experiencing social exclusion more likely to report these. Young people generally preferred face-to-face support, but those facing relational difficulties were more open to online support.Conclusions. This study highlights the additional needs and challenges faced by young people dealing with both social exclusion and mental ill-health. The barriers to seeking help are stronger for these young people and more concerted efforts to reduce stigma, improve mental health literacy, and increase access to trusted information sources, need to be developed to address these barriers. Further research and initiatives need to focus on the structural factors that socially exclude young people and exacerbate inequitable access to mental health services.