Adolescents’ perceived barriers and facilitators to seeking and accessing professional help for anxiety and depressive disorders: a qualitative interview study

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Abstract

Anxiety and depressive disorders are the most common mental health disorders in adolescents, yet only a minority of young people with these disorders access professional help. This study aims to address this treatment gap by improving our understanding of barriers and facilitators to seeking/accessing professional help as perceived by adolescents with anxiety/depressive disorders identified in the community. Twenty-two adolescents, aged 11–17 years, who met diagnostic criteria for a current anxiety and/or depressive disorder were identified through school-based screening. In-depth qualitative interviews were conducted one-to-one with each adolescent and adolescents’ parents were interviewed separately for the purpose of data triangulation. Data were analysed using reflexive thematic analysis. We identified four themes capturing adolescent perceived barriers and facilitators to seeking/accessing professional help for anxiety and depressive disorders: (1) making sense of difficulties, (2) problem disclosure, (3) ambivalence to seeking help, and (4) the instrumental role of others. Barriers/facilitators identified within each theme reflect important developmental characteristics of adolescence, such as a growing need for autonomy and concerns around negative social evaluation. At the same time, the results highlight adolescents’ dependency on other people, mainly their parents and school staff, when it comes to successfully accessing professional help for their mental health difficulties. This study identifies a number of barriers/facilitators that influence help-seeking behaviour of adolescents with anxiety and/or depressive disorders. These factors need to be addressed when targeting treatment utilisation rates in this particular group of young people.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00787-020-01707-0.

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Most cited references 47

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Using thematic analysis in psychology

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Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.

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Reflecting on reflexive thematic analysis

Virginia Braun, Victoria Clarke (2020)

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Author and article information

Contributors

Tessa Reardon:

ORCID: http://orcid.org/0000-0002-9298-091X

tessa.reardon@psy.ox.ac.uk

Journal

Journal ID (nlm-ta): Eur Child Adolesc Psychiatry

Journal ID (iso-abbrev): Eur Child Adolesc Psychiatry

Title: European Child & Adolescent Psychiatry

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 1018-8827

ISSN (Electronic): 1435-165X

Publication date (Electronic): 27 January 2021

Publication date PMC-release: 27 January 2021

Publication date (Print): 2022

Volume: 31

Issue: 6

Pages: 891-907

Affiliations

[1 ]GRID grid.9435.b, ISNI 0000 0004 0457 9566, School of Psychology and Clinical Language Sciences, , University of Reading, ; Reading, RG6 6AL UK

[2 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, The Oxford Institute of Clinical Psychology Training and Research, , University of Oxford, ; Oxford, OX3 7JX UK

[3 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, Departments of Experimental Psychology and Psychiatry, , University of Oxford, ; Oxford, OX2 6GG UK

[4 ]GRID grid.12082.39, ISNI 0000 0004 1936 7590, School of Psychology, , University of Sussex, ; Brighton, BN1 9RH UK

Author information

Tessa Reardon http://orcid.org/0000-0002-9298-091X

Article

Publisher ID: 1707

DOI: 10.1007/s00787-020-01707-0

PMC ID: 9209355

PubMed ID: 33502596

SO-VID: a5d1c23b-32b8-4692-ab0e-425b47204d86

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Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 9 June 2020

Date accepted : 16 December 2020

Funding

Funded by: University of Reading

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ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: adolescence,anxiety disorders,depressive disorders,help-seeking,access,barriers

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ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: adolescence, anxiety disorders, depressive disorders, help-seeking, access, barriers

Adolescents’ perceived barriers and facilitators to seeking and accessing professional help for anxiety and depressive disorders: a qualitative interview study

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Most cited references 47

Using thematic analysis in psychology

Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

Reflecting on reflexive thematic analysis

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