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Inequitable access to mental healthcare for socially excluded adolescents

Author

Listed:
  • Kate Filia
  • Shu Mei Teo
  • Naheen Brennan
  • Tamara Freeburn
  • David Baker
  • Vivienne Browne
  • Myriam Ziou
  • Jana Menssink
  • Amity Watson
  • Ellie Brown
  • Alesha Prasad
  • Eóin Killackey
  • Patrick D McGorry
  • Debra Rickwood
  • Sue M Cotton
  • Caroline X Gao

Abstract

Background: Adolescence is a critical period for mental health and social exclusion, a key social determinant of mental health. Early intervention approaches are key to mitigating the impact of mental ill-health during adolescence, however social exclusion can create additional barriers to accessing care. Aim: We aimed to better understand help-seeking experiences of adolescents facing co-occurring social exclusion and mental ill-health, including sources of support, barriers and preferences for service provision. Method: Cross-sectional data were analysed, from the 2022 Mission Australia Youth Survey ( N  = 18,800). Adolescents aged 15 to 19 years were recruited from around Australia, through schools, community organisations and digital platforms. Indices of four domains of social exclusion (housing, finances, relational and education/employment) were created using existing Youth Survey variables, and supplemented with demographic characteristics, psychological distress and help-seeking behaviours (perceived need, mental health supports, barriers to access and preferences). Relationships between social exclusion domains, mental health concerns and help-seeking behaviours were explored using logistic regression models. Results: A total of 9,743 young people reported having needed mental health support, yet only 58.1% reportedly sought support ( n  = 5,565). Social exclusion domains were associated with different help-seeking behaviours: housing challenges with higher help-seeking (OR = 1.28; 95% CI [1.15, 1.42]); relational difficulties and edu-employment issues with lower (OR = 0.75; 95% CI [0.68, 0.83] and OR = 0.82; 95% CI [0.75, 0.89]). Stigma, confidentiality concerns, cost and not knowing where to seek help were common barriers to help-seeking; those experiencing social exclusion more likely to report these. Participants reported a strong preference for face-to-face support. Conclusions: This study highlights the additional needs and challenges faced by adolescents dealing with both social exclusion and mental ill-health. With greater barriers to help-seeking, concerted efforts are needed to reduce stigma, improve mental health literacy and increase access to trusted information sources. Further initiatives should focus on structural factors that socially exclude young people and exacerbate inequitable access to mental healthcare.

Suggested Citation

  • Kate Filia & Shu Mei Teo & Naheen Brennan & Tamara Freeburn & David Baker & Vivienne Browne & Myriam Ziou & Jana Menssink & Amity Watson & Ellie Brown & Alesha Prasad & Eóin Killackey & Patrick D McG, 2024. "Inequitable access to mental healthcare for socially excluded adolescents," International Journal of Social Psychiatry, , vol. 70(7), pages 1267-1278, November.
    • Handle: RePEc:sae:socpsy:v:70:y:2024:i:7:p:1267-1278
    DOI: 10.1177/00207640241262703
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    References listed on IDEAS

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    1. van Buuren, Stef & Groothuis-Oudshoorn, Karin, 2011. "mice: Multivariate Imputation by Chained Equations in R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 45(i03).
    2. Adrian Tomyn & Robert Cummins, 2011. "The Subjective Wellbeing of High-School Students: Validating the Personal Wellbeing Index—School Children," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 101(3), pages 405-418, May.
    3. Kate Filia & Henry Jackson & Sue Cotton & Eoin Killackey, 2019. "Understanding what it means to be socially included for people with a lived experience of mental illness," International Journal of Social Psychiatry, , vol. 65(5), pages 413-424, August.
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