‘It’s a bit taboo’: a qualitative study of Norwegian adolescents’ perceptions of mental healthcare services

Tharaldsen, Kjersti Balle; Stallard, Paul; Cuijpers, Pim; Bru, Edvin; Bjaastad, Jon Fauskanger

doi:10.1080/13632752.2016.1248692

Cited by 23 publications

(22 citation statements)

References 30 publications

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“…Young people’s broader perceptions of help-seeking were reported as barriers in 39% of studies, and as facilitators in 4%. This subtheme captured young people’s general attitudes towards mental health and help-seeking [ 31 , 49 , 53 , 55 , 59 ], help-seeking expectations [ 20 , 27 , 31 , 33 , 37 , 38 , 46 , 48 , 54 , 59 , 68 , 75 ] and perceptions about how help-seeking reflects on their character, such as perceiving help-seeking as a sign of weakness [ 21 , 49 , 54 , 60 , 63 , 73 , 75 ]. The latter was reported in all studies that included male-only samples.…”

Section: Resultsmentioning

confidence: 99%

Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies

Radež

Reardon

Creswell

et al. 2020

Eur Child Adolesc Psychiatry

590

437

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Mental health disorders in children and adolescents are highly prevalent yet undertreated. A detailed understanding of the reasons for not seeking or accessing help as perceived by young people is crucial to address this gap. We conducted a systematic review (PROSPERO 42018088591) of quantitative and qualitative studies reporting barriers and facilitators to children and adolescents seeking and accessing professional help for mental health problems. We identified 53 eligible studies; 22 provided quantitative data, 30 provided qualitative data, and one provided both. Four main barrier/facilitator themes were identified. Almost all studies (96%) reported barriers related to young people's individual factors, such as limited mental health knowledge and broader perceptions of help-seeking. The second most commonly (92%) reported theme related to social factors, for example, perceived social stigma and embarrassment. The third theme captured young people's perceptions of the therapeutic relationship with professionals (68%) including perceived confidentiality and the ability to trust an unknown person. The fourth theme related to systemic and structural barriers and facilitators (58%), such as financial costs associated with mental health services, logistical barriers, and the availability of professional help. The findings highlight the complex array of internal and external factors that determine whether young people seek and access help for mental health difficulties. In addition to making effective support more available, targeted evidence-based interventions are required to reduce perceived public stigma and improve young people's knowledge of mental health problems and available support, including what to expect from professionals and services.

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Section: Resultsmentioning

confidence: 99%

Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies

Radež

Reardon

Creswell

et al. 2020

Eur Child Adolesc Psychiatry

590

437

View full text Add to dashboard Cite

show abstract

“…Most of the studies (n = 18) were conducted in Australia, followed by the United States (n = 12) and the United Kingdom (n = 5). The majority of the studies were cross sectional (n = 36) , thirteen studies were qualitative [62][63][64][65][66][67][68][69][70][71][72][73][74] and six used a mixed-method design [75][76][77][78][79][80]. Three PhD dissertations and one conference abstract were included in the grey literature.…”

Section: Question 1: Help-seeking Barriers and Facilitatorsmentioning

confidence: 99%

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

et al. 2020

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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 April 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: Ninety 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 the 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.

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“…I'm done with it, but then it comes back on. (5) Disagreement about the problem was often mentioned as a reason for the adolescents' inability to participate. Some compared psychological assessment to taking tests in school.…”

Section: She Dug Up Things From the Past About Suicidal Thoughts And mentioning

confidence: 99%

“…Inpatient units offer acute mental health services for the most acutely ill adolescents, and there is an increasing need for this type of service ( 4 ). However, stigma and a distinct need for autonomy may hinder adolescents from seeking or receiving help ( 5 ). Thus, acute inpatient treatment can also result in involuntary treatment ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

I’m not a diagnosis: Adolescents’ perspectives on user participation and shared decision-making in mental healthcare

Bjønness

Grønnestad

Storm

2020

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

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Background: Adolescents have the right to be involved in decisions affecting their healthcare. More knowledge is needed to provide quality healthcare services that is both suitable for adolescents and in line with policy. Shared decision-making has the potential to combine user participation and evidence-based treatment. Research and governmental policies emphasize shared decision-making as key for high quality mental healthcare services. Objective: To explore adolescents' experiences with user participation and shared decision-making in mental healthcare inpatient units. Method: We carried out ten in-depth interviews with adolescents (16-18 years old) in this qualitative study. The participants were admitted to four mental healthcare inpatient clinics in Norway. Transcribed interviews were subjected to qualitative content analysis. Results: Five themes were identified, representing the adolescents' view of gaining trust, getting help, being understood, being diagnosed and labeled, being pushed, and making a customized treatment plan. Psychoeducational information, mutual trust, and a therapeutic relationship between patients and therapists were considered prerequisites for shared decision-making. For adolescents to be labeled with a diagnosis or forced into a treatment regimen that they did not initiate or control tended to elicit strong resistance. User involvement at admission, participation in the treatment plan, individualized treatment, and collaboration among healthcare professionals were emphasized. Conclusion: Routines for participation and involvement of adolescents prior to inpatient admission is recommended. Shared decision-making has the potential to increase adolescents' engagement and reduce the incidence of involuntary treatment and re-admission to inpatient clinics. In this study, shared decision-making is linked to empowerment and less to standardized decision tools. To be labeled and dominated by healthcare professionals can be a barrier to adolescents' participation in treatment. We suggest placing less emphasis on diagnoses and more on individualized treatment.

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‘It’s a bit taboo’: a qualitative study of Norwegian adolescents’ perceptions of mental healthcare services

Cited by 23 publications

References 30 publications

Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies

Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies

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

I’m not a diagnosis: Adolescents’ perspectives on user participation and shared decision-making in mental healthcare

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