What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review

Abstract

Background: Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap. Methods: Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 and updated in March 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed and findings summarised using a narrative synthesis. Results: 90 studies meet the inclusion criteria for this review for barrier and facilitators (n=54) and interventions (n=36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements. Conclusion: Most of interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.

Online administration of a pilot mindfulness-based intervention for adolescents: Feasibility, treatment perception and satisfaction

“…Prior research indicates that adolescents with reduced help-seeking behaviors and the lowest retention presented with more severe psychiatric problems, compared to those with moderate symptom levels who sustain engagement long enough to see beneficial impacts (Aguirre et al, 2020;Roedelof et al, 2013). Our results found similar associations to support our third hypothesis, that increased pre-test depression and anxiety symptomology was significantly associated with reduced utility of the online intervention.…”

“…Early evidence during the COVID-19 pandemic suggests symptoms associated with mental health difficulties (e.g., increased emotional distress) and physical health (e.g., headache) may further reduce help-seeking and engaging behaviors (Aguirre et al, 2020). The inaccessibility of social supports (Jung & Jun, 2020) and mental health services during the COVID-19 pandemic (Golberstein et al, 2020), particularly for adolescents with severe mental illnesses (Guessoum et al, 2020), were significantly related to poorer adjustment and increased depression (Ellis et al, 2020).…”

Adverse Mental Health of Juvenile Delinquency and Suicide: A Bibliometrics Study and Visualization Analysis via CiteSpace

“…Teenage is defined as 13-17 years old. Adolescents who are most in need of mental health care are reluctant to seek help, since they often experience many troubles, rejections or barriers (Aguirre et al, 2019). Children's metal health is associated with prospective delinquent outcomes.…”

Interventions to reduce stigma towards mental disorders in young people: protocol for a systematic review and meta-analysis

“…Morris et al 10 evaluated the characteristics and capacities of mental health services for individuals less than 18 years of age in 42 low-income and middle-income countries and found that standard mental health services, lacking properly trained and/or specialised personnel, offer a limited range of benefits for this age group. Moreover, the help-seeking process in this population is further hindered by the stigma towards mental health problems in young people 11 12…”

“…The most recent research on stigma in non-adult populations has focused on the following aspects: (1) sociocultural processes involved in the development of mental health stigma at early ages18; (2) contributing factors to the stigma towards mental health problems in children and adolescents11 12; and (3) the potential stigmatising effect of selective interventions in mental health in educational contexts 19. The only relatively recent integrative report assessing the effectiveness of interventions to reduce stigma towards mental disorders in young people focused on the process of implementing an antistigma programme in Canadian schools.…”