How do we improve mental health services for young people?

In brief

Adolescence is the period of highest risk for development of mental illness, but it’s also the age group least likely to seek out mental health services. Although there are calls to rethink traditional service designs to develop youth-focused services, few studies have tried to understand the reasons for this lack of engagement and whether this type of service redesign would make a difference.

To better understand the reasons why youth don’t seek out mental health services, researchers undertook a systematic review of the published literature on young people’s views of mental health services in the United Kingdom.

EENet is pleased to feature a Research Snapshot on the article, “Young people’s views of UK mental health services,” by Belinda Lennox, James Plaistow, Peter Jones, Jon Wilson, Kim Masson, Damaris Koch, and Rosemary M. Stark. The article appeared in Early Intervention in Psychiatry, vol 8 (2014). Read the summary of this article below or access the PDF.

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

What you need to know

Researchers found that young people in the UK have consistent views of mental health services. This study emphasizes the importance of worker qualities/skills, raising awareness of mental health issues and services, and offering services that promote self-reliance in young people. Addressing the lack of access to services, stigma around mental health issues, medicalization of mental health problems, and a lack of continuity of care was also found to be important. 

What is this research about?

Adolescence is the period of highest risk for development of mental illness, but it’s also the age group least likely to seek out mental health services. Although there are calls to rethink traditional service designs to develop youth-focused services, few studies have tried to understand the reasons for this lack of engagement and whether this type of service redesign would make a difference. 

What did the researchers do?

To better understand the reasons why youth don’t seek out mental health services, researchers undertook a systematic review of the published literature on young people’s views of mental health services in the United Kingdom. 

The review was conducted in two parts: first, they mapped out all the published literature in this area, and then they did an in-depth review of the quality and findings of those studies. Of these:

  • 14 studies were based on the views of adolescents under age 18;
  • 15 studies covered the views of people in their late teens and early twenties (the period of transition from child to adult services in the UK).

What did the researchers find?

Young people in the UK have consistent views of mental health services. These views were analyzed according to themes, and are described below.

Accessibility of services

Accessibility was the most prevalent theme, consisting of sub-themes such as location, timing, access without a waiting list, services being flexible to young people’s needs, and services having characteristics and using language that made young people feel comfortable. The youth appreciated receiving help with practical problems, meeting in a relaxed atmosphere, and focusing on activities and building social support networks. 

Worker qualities/skills

Young people listed a number of key qualities they found helpful in their service providers. These included: being approachable, genuine, positive, friendly, warm and kind, and skilled and knowledgeable. 

They also highly valued service providers who were aware of and able to maintain confidentiality. Their relationship with their service provider, and having someone to talk to and listen to them, were also important features. 

Self-reliance

Youth wanted mental health services to promote self-reliance and support them in becoming more independent in the long term.

Stigma

Youth cited stigma as one reason not to seek help or identify as having a mental illness. The term ‘mental health’ itself was seen as negative, as ‘someone who wuz a bit of a fruit loop’ in the words of one youth.

Lack of information/access to services

Youth felt that their needs were not severe enough to be considered mental health issues, or did not identify themselves as having mental health concerns, despite having experienced self-harm and other behaviours. They were also unaware of the services available to them. Young people said they needed more information about mental health, mental health services, and what they could expect from these services. 

Medicalization of problems

A number of studies highlighted young peoples’ feeling that they were not listened to when they sought help from health professionals, and that general practitioners simply offered medication without any other supports. 

Lack of continuity of care

Young people experienced frustration at having to retell their story to numerous counsellors on multiple occasions. They also cited transitioning from youth to adult services as another gap in continuity of service. 

How can you use this research

Understanding youth perceptions of mental health services can support the development of tailored initiatives that better meet their needs. These perceptions have been echoed in Ontario, where youth have noted similar views of mental health services.

About the researchers

Belinda Lennox is an associate professor and clinical senior lecturer at the University of Oxford Department of Psychiatry Medical Sciences Division.
James Plaistow is a clinical psychologist at Cambridge and Peterborough Foundation Trust.
Peter Jones is Professor of Psychiatry & Head of the Department of Psychiatry at the University of Cambridge.
Dr. Jon Wilson is a Consultant Psychiatrist with the Norfolk and Suffolk NHS Foundation Trust.
Kim Masson is Service Manager of Cameo Early Intervention Service at Cambridgeshire and Peterborough NHS Foundation Trust.
Damaris Koch is a consultant psychiatrist at Cambridgeshire and Peterborough NHS Foundation Trust.
Rosemary M. Stark is a librarian at Norfolk and Suffolk Mental Health Foundation Trust.

This Research Snapshot is based on their review article: “Young people's views of UK mental health services,” which was published in Early Intervention in Psychiatry vol 8, no 1 (2014), DOI: 10.1111/eip.12060. 

Keywords

Adolescent, health attitudes, patient satisfaction, youth service

This Research Snapshot is based on an article that has been critically appraised for quality and susceptibility to bias.

 

Evidence Exchange Network (EENet) has partnered with the Knowledge Mobilization Unit at York University to produce Research Snapshots in the field of mental health and addictions in Ontario. This summary was written by Ghada Khoraych .