1 - (Sym 113) Mixed Methods Examination of Youth-reported Barriers to Accessing Mental Health Services

Background: Unmet needs in youth mental health services have been repeatedly noted as a public health crisis, with up to 80% of youth with mental health needs not receiving any services at all. To better understand the low rates of treatment access, studies have identified a variety of logistical (e.g. limited mental health providers) and intangible (e.g. beliefs about mental health) barriers that prevent youth from connecting to services. However, much of this literature investigates treatment access barriers from caretaker perspectives only; as such, knowledge of youth-perceived barriers to treatment is lacking.

Methods: Participants were 211 youths ages 11-17 who took part in a study testing the utility of single session, online mental health interventions for youth, and who provided a response to an open-ended question regarding barriers to accessing mental health services ("what got in the way of getting mental health treatment when you needed it?”). About half the participants identified as White (50.23%), most were female (92.49%), and 57.35% identified with diverse sexual orientations. Qualitative responses were extracted for thematic coding in which three coders developed a coding manual, met a pre-registered reliability of a Kappa of .80 or higher, and independently coded all responses. Pre-registration of all methods and research questions are available on https://osf.io/9d2ev.

Results: 13 themes of youths’ self-identified barriers to accessing mental health treatment: general issues with parents, communication issues with parents, parent resistance, general fear, fear of disclosure, fear of stigma, concerns about mental health services, lack of knowledge about mental health services, lack of access to mental health resources, perceived subclinical severity, financial concerns, not feeling supported, and other personal constraints. Parent-related codes, combined, represented 32% of the treatment access barriers, with financial concerns (13%) as the next most-endorsed code. Numerically, more barriers to accessing treatment were reported by Asian youth (M = 1.64, SD = 0.93), teens age 17 or older (M = 1.46, SD = 0.74), participants who reported uncertainty with respect to their gender identity (M = 1.38, SD = 0.87), and bisexual participants (M = 1.33, SD = 0.60).

Conclusions: More than one-third of treatment access barriers endorsed by youth involved their parents. This result suggests the need to evaluate and address treatment access barriers based on multiple perspectives—including both parents and their children.