Adolescents’ help-seeking intentions for mental health problems: a mixed-methods study of attitudes and barriers

Abstract Background Adolescents frequently experience mental health problems, yet many do not receive professional support, highlighting the need to understand their attitudes, barriers, and help-seeking intentions. Existing work has rarely combined mixed-method approaches using gender-varied vignettes spanning multiple disorder groups with qualitative exploration of adolescents’ own explanations. This mixed-methods study aims to examine adolescents’ attitudes toward professional help-seeking and perceived barriers, and to explore gender- and disorder-specific patterns in help-seeking intentions. Method In Study I, 645 adolescents (14–21 years) from Swiss secondary and vocational schools completed a digital questionnaire including three mental health vignettes (internalizing, externalizing, dependence/addictive-pattern related disorders) and one control vignette (lovesickness). Participants rated problem recognition, perceived need for help, and intentions to seek help, and ranked preferred informal and professional help sources in response to each vignette. In Study II, 60 adolescents took part in semi-structured focus group discussions, which explored experiences, attitudes, and perceived barriers to professional help-seeking in greater depth. Qualitative data were analyzed using inductive content analysis to complement and contextualize the quantitative findings. Results Study I found that adolescents recognized internalizing disorders most accurately, followed by dependence/addictive-pattern related disorders and externalizing disorders, but often underestimated the need for help. Despite recognizing mental health problems, intentions to seek professional help remained low across vignettes, and informal sources such as parents and friends were predominantly ranked as first‑line options. Male adolescents showed lower recognition of the need for help than females and were less likely to recommend professional sources. Study II highlights limited knowledge about professional help sources among adolescents, a marked preference for self-help among young men, and a wish for more education on mental health and increased anonymity of help sources as well as diverse, youth-friendly contact modalities. Conclusions The combination of low intentions to seek help from professional sources, limited knowledge of available services, and strong reliance on informal help suggests a need for broad mental health literacy interventions. Such initiatives may benefit from being tailored to different genders and disorder types and from incorporating adolescents’ own suggestions, including school-based education, anonymous access options, and diverse modalities for contacting professional services.