What Teens Want: Barriers to Seeking Care for Depression

Abstract

This study examined the experiences of teenagers seeking and receiving care for depression from primary care providers. We investigated teens' perceived barriers in obtaining care to determine how primary care can effectively address depressed teens' stated needs. In-depth individual (n = 15) and focus group (n = 7) interviews with adolescents were conducted and analyzed using grounded theory and prominent themes were identified. Teenagers reported faring best when providers actively considered and reflected upon the teenagers' developmentally appropriate desires to be normal, to feel connected, and to be autous. These goals are achieved by providers establishing rapport, exchanging information about depression etiology and treatment, and helping teens make decisions about their treatment. To the extent that providers improve efforts to help teens feel normal, autonomous, and connected, the teens report they are more likely to accept treatment for depression and report success in treatment.

Unmet Health Care Need in US Adolescents and Adult Health Outcomes

“…2,5,6 In particular, young people with mental health needs may perceive many barriers to accessing care, and the ability of health care providers to engage and communicate well is crucial to the initiation and success of treatment. 27 Interventions have been shown to improve the perceived quality of consultations with young people and increase utilization, particularly among the most vulnerable adolescents. 2,6,15 In turn, there are good reasons to believe that increased utilization of health services among adolescents may result in improved adult health outcomes.…”

From Prototype to Product: Development of a Primary Care/Internet Based Depression Prevention Intervention for Adolescents (CATCH-IT)

“…Effective treatment approaches for reducing the risk of major depression in adolescence include group cognitive-behavioral and individual interpersonal psychotherapy Clarke et al 2001;Garber 2006;Gillham et al 2000;Horowitz et al 2007). Barriers for such treatment implementation include the social stigma of seeking mental health treatment and also the financial burden of treatment (Jaycox et al 2006;Wisdom et al 2006). Internet-based interventions can avoid these stigma concerns due to the anonymity allowed by the Internet.…”

Cognitive Behavioral Therapy in Primary Care for Youth Declining Antidepressants: A Randomized Trial

“…5,6 However, a 2004 warning from the Food and Drug Administration regarding AD-associated suicidality contributed to reduced prescription of ADs over many years, with no corresponding increase in psychotherapy rates. [7][8][9][10] Among depressed youth in primary care, as many as 50% decline pharmacotherapy. 5 Of those who do initiate ADs, as many as half fail to maintain adherence or duration sufficient to realize the expected benefit.…”