The Role of Informal Sources of Help In Young People’s Access To, Engagement With, And Maintenance In Professional Mental Health Care—A Scoping Review

Abstract

Young people can be reluctant to seek help for a mental health problem due to many factors, and research suggests that early and meaningful intervention within this demographic is essential to support improved quality of life and reduce youth death by suicide. The role of informal sources of help in youth mental health help-seeking pathways is an important subject however, there are no reviews on this topic. The aim of this scoping review was to map the existing literature regarding how informal sources of help affect young people’s access to, engagement with and maintenance in professional mental health care. Nine databases were searched for original peer-reviewed research published between 1994 and 2021 with young people aged 10–25 years. A thematic analysis was performed on 32 studies that met selection criteria. Two key themes were identified: 1. Informal helpers as supportive intermediaries and 2. Informal helpers as obstructive forces. This review found that informal sources of help are dynamic and essential pathway agents in helping or hindering young people with accessing and staying engaged in professional mental health care. Further research on this topic with young people about their actual help-seeking experiences is required. Through an improved understanding of how these interpersonal relationships function within a young person’s help-seeking process, on a spectrum of supportive to obstructive behaviour, services and practitioners can ensure the provision of responsive and appropriate support to young people and their families, facilitating service use and ensuring better outcomes for young people’s mental health and quality of life.

Factors that impact mental health help‐seeking in Australian adolescents: a life‐course and socioecological perspective

“…We also found that child's disability status and low school engagement were more related to formal help‐seeking, whereas single‐parent family composition and poor relationships with peers were more associated with close and broad informal help‐seeking. This suggests that formal help‐seeking appears to be more attributed to an individual's functional impairments (Doll et al., 2021) and lack of involvement in education (Klassen, Stewart, & Lapshina, 2021), whereas informal help‐seeking is more related to interpersonal relationships (Lynch, Moorhead, Long, & Hawthorne‐Steele, 2023). Further research is needed to explore potential mechanisms between these intrinsic and extrinsic barriers and different sources of help.…”

“If you don’t actually care for somebody, how can you help them?”: Exploring Young People’s Core Needs in Mental Healthcare—Directions for Improving Service Provision

“…Services can become truly developmentally appropriate, and youth centred (Rickwood et al, 2019 ; Sawyer et al, 2018 ) with suitable environments, integrated services and specialist youth trained staff (Dopp & Lantz, 2020 ; McGorry et al, 2019 ), an approach that aligns with community mental healthcare approaches of person-centredness, earlier interventions and life course perspectives (Sowers et al, 2022 ). Youth centred services can consider supporting the essential role of caregivers, who are managing other responsibilities, such as employment and childcare, and who provide essential resources for young people to attend healthcare (Lynch et al, 2023 ; Thornicraft et al, 2016 ). Services can also consider how their policies can result in the exclusion of groups of people who traditionally experience marginalization from statutory services (De Anstiss & Ziain, 2009; Fanning, 2012 ; Masuda et al, 2009 ) and ensure that service design includes a diversity of perspectives (Sowers et al, 2022 ).…”

“…The social factors discussed as directly affecting youth mental health help-seeking include stigma, community attitudes and cultural expressions of distress (Byrow et al, 2020 ; Goodwin et al, 2016 ; Gulliver et al, 2010 ; Lynch et al, 2018 ; Michelmore & Hindley, 2012 ; Nam et al, 2010 ; Rowe et al, 2014 ). Friends and family are often reported as the preferred sources of help for mental health problems (Michelmore & Hindley, 2012 ; Rickwood et al, 2005 ; Rowe et al, 2014 ) and can act as significant barriers or facilitators in professional help-seeking (Lynch et al, 2023 ). Gatekeepers such as teachers, youth workers, or GPs are also important in supporting access to professional help (Leavey et al, 2011 ; Quinn et al, 2009 ; Rickwood et al, 2005 , 2007 ), especially for young people with migrant or refugee experiences (De Anstiss et al, 2009 ; Ellis et al, 2010 ) or those experiencing homelessness (Collins & Barker, 2009 ; Crosby et al, 2018 ).…”

“…Many research studies have used hypothetical scenarios or survey instruments and there is evidence to suggest that investigating intentions to seek help cannot predict or be translated into actual help-seeking behaviour (Eisenberg et al, 2012 ; Hughes & Huby, 2004 ). Therefore, qualitative research is essential with young people with lived experiences (PLE) regarding their mental health and associated help-seeking pathways (Law et al 2020 ; Lynch et al, 2023 ). In addition, the negative labelling of young people as reluctant, resistant or unwilling can obscure the complex cost–benefit assessment processes (Chan, 2013 ) that result in non-help-seeking or early treatment exits.…”

“…This can distract attention from the role of services in providing appropriate healthcare (Jones et al, 2017 ; Persson et al, 2017 ) and result in missed opportunities for service improvement. Thus, there is a distinct need for new directions and in-depth inquiry with mental health service users (Law et al 2020 ; Lynch et al, 2023 ), as increasing understanding of experiences can inform measures to reduce health disparities affecting young people and support practitioners and services to better engage, facilitate and keep young people in mental healthcare (Breslin et al, 2022 ; Medlow et al, 2010 ; Raviv et al, 2009 ; Rughani et al, 2011 ).…”