‘Kids have really no way to access support, especially without their parents knowing’: a qualitative study of access to mental health support among adolescents

We explored adolescents' perceived barriers and facilitators to accessing formal and informal mental health support during the COVID-19 pandemic response. In this qualitative descriptive study, 30 semi-structured online interviews were conducted between June and August 2021 with adolescents (13-18 years old, 53.3% girls) living in Canada and analyzed using reflexive thematic analysis. Four themes were constructed: 1) perceptions of others being unable to understand and/or help them, 2) discomfort disclosing concerns to a potential helper, 3) concerns about parents and/or peers finding out due to questioned privacy and confidentiality, particularly in the school context, and 4) perceptions about their capacity to access formal support. Themes were related to participants' perceptions of parent/guardian and peer beliefs regarding mental health and help seeking. Parents were experienced as gatekeepers to adolescents' access to mental health services and resources. This study highlights the importance of considering adolescent development in accessibility, particularly their increasing autonomy. Despite schools often being regarded as the ideal location to first connect youth with mental health services, adolescents continue to experience many barriers to seeking and accessing help within this context. Results have implications for improving access to mental health support for adolescents beyond the pandemic, both within and outside of schools.