Barriers to treatment for mental health problems in Swedish youth

Abstract Background Many who would benefit from treatment for mental illness never seek care. The aim is to examine barriers to the initiation of mental health treatment among young people with a perceived need for care. A further objective is to explore the relationship between depression and anxiety severity ratings and perceived barriers. Methods Data were derived from a national Swedish sample of 23-year-olds (n = 3,236) collected in 2024. Respondents with a self-reported need for treatment for mental health problems in the past 12 months were asked about treatment initiation. A subsample of those not initiating treatment were asked about the presence of 12 possible attitudinal and structural barriers to treatment seeking. Depression and anxiety severity (mild, severe) were measured with PHQ-8 and GAD-7, respectively. Group differences were examined with chi square tests. Results Among those who perceived a need for treatment (38% of the sample), 53% did not seek treatment. The most common reason was the belief that the problem would resolve on its own (50.2%), followed by not knowing where to turn (30.2%) and thinking care would not help (29.3%). A total of 21.0% reported shame as a barrier. Attitudinal barriers were much more common (79.1%) than structural barriers (46.4%). A couple of reasons varied by level of current severity: compared to individuals with mild PHQ-8 or GAD-7, those with severe levels more often reported that care would not help, fear of compulsory care, and previous negative experience with care; but less often thought that the problem would resolve on its own. There were no differences in attitudinal or structural barriers across severity rating. Severity did not predict differential treatment seeking. Conclusions Attitudinal barriers are major barriers to seeking treatment. Severity appears a less important determinant for seeking treatment and for attitudinal and structural reasons for not initiating care. Key messages • Beliefs about treatment and what mental health can offer appear as important barriers to care. • Those with more severe depression/GAD have more negative experience and beliefs about treatment, but less often think the problem will resolve on its own.