Family and Peer Mental Health, Help-Seeking Messages and Decision-Making Among Youth Attending a Canadian Integrated Center for Mental Health Challenges

Background and purpose: Untreated mental illness has enormous social and economic costs to both the individual and their family. Thus, understanding the pathways youth and young adults (YYA) take in accessing mental health (MH) services is fundamental in supporting early and ongoing access to these services, thereby promoting health equality across the life course. Research has shown that family experiences with mental illness, knowledge and attitudes about MH can influence help-seeking pathways for YYAs. This qualitative study set out to examine whether YYAs that attend an outpatient clinic for MH challenges report that important people in their lives suffer from MH disorders, and how these experiences impede or facilitate YYAs MH service use.    

Method: Data were collected as part of a larger study examining MH service utilization with YYAs between the ages of 14-24 that attended a walk-in clinic at Foundry BC (integrated service center) in Canada for MH problems (e.g. anxiety, depression) between the years 2018-2019. Fourteen participants were recruited using purposive and theoretical sampling. In-depth interviews were conducted by graduate students, lasting one hour, and were audiotaped and transcribed. Example questions included: 1) Do important people in your life live with MH challenges? 2) If so, have they used MH services for these challenges? Applying grounded theory methodology (Charmaz, 2006) two analysts conducted both open and focused coding, and met for constant comparison, and consensus building. All data were analyzed in NVivo.   

Results: Sample demographics included mean age 21 (SD=2), 36% female, 50 % male, 14% transgender individuals, 93% White, 7% Latin American. The Patient Health Questionnaire depression scale (PHQ8) mean score was 10.4 (SD=5), and the Generalized Anxiety Disorder (GAD7) mean score was 8.8 (SD=4.9) indicating mild to moderate levels of anxiety and depression. All YYAs reported having a family member who had experienced MH problems. One youth stated, “my mom and my sister are quite prominent in mental health cause they were struggling with it when I was growing up so they understand”. Youth also reported positive, negative and mixed messages they received from family members about seeking MH services.  One participant said, “He’s [dad] had his own problems with mental health that he never got treated and he has the expectation of other people that they can just move on”. The majority of the YYAs reported peers (e.g. friends, significant others) experiencing MH problems. One YYA stated, “everyone of my close personal friends. I can’t think of a single person in my life that has a strong influence on me that hasn’t dealt with it [mental health issue]”.  Finally, YYAs reported encouraging family and peers to seek MH services for their MH problems. 

Conclusion and Implications: Help-seeking behaviours learned through what YYAs hear, see, and experience from their family members and peers seems to play a significant role in their decision to seek their own treatment. These results suggest that in order to bring YYAs to services sooner, practitioners must consider family and peer messages and behaviors around help-seeking.