Access to Addiction and Mental Health Treatment for Transition Aged Youth and Their Families

Background and Purpose: Transition aged youth (aged 16-24) are in a developmental transition between childhood and adulthood and the stage in which most mental health and addiction related concerns emerge. Transition aged youth have the highest rates of mental health, substance use, and gambling concerns across all age groups with increases in prevalence over the last decade. Despite these high rates, transition aged youth have the most unmet health care needs. More than 75% of youth in Canada report not receiving the type of specialized treatment needed and 52% dropping out of treatment. There are many barriers and gaps that contribute to the unmet mental health care needs of youth including lack of available and appropriate services, high costs, long wait times, crisis driven services, fragmented and siloed services, lack of smooth transition between child and adult services, stigma, racism, and discrimination, and lack of culturally appropriate treatment. Levesque et al developed a framework to better understand health care access and they define access to treatment as “the opportunity to reach and obtain appropriate health care services in situations of perceived need for care.” This healthcare access framework conceptualizes accessibility across five structural dimensions: 1) approachability, 2) availability and accommodation, 3) affordability, 4) appropriateness and adequacy, and 5) acceptability. The purpose of this study was to explore access to addiction and mental health services for youth and we examined the following research question: How is access to youth addiction and mental health treatment and services described by parents, youth, and service providers?

Methods: This qualitative study was a university-community partnership exploring the experiences of youth with mental health concerns and their families from the perspectives of youth, caregivers, and service providers. We conducted semi-structured interviews and used thematic analysis to analyze data.

Results: The study involved 25 participants (n=11 parents, n= 4 youth, n=10 service providers). We identified six themes related to structural barriers impacting access to addiction and mental health services for youth: 1) Approachability – “The biggest barrier in accessing mental health support is where to look,” 2) Availability – “There’s always going to be a waitlist,” 3) Affordability – “I have to have money to be healthy,” 4) Appropriateness – “They weren’t really listening to my issues,” 5) Acceptability – “Having more of a welcoming and inclusive system,” and 6) Policies and laws – “Health laws aren’t doing what they need to do.”

Conclusion and Implications: Our study identified five structural barriers that map onto the Levesque et al. healthcare access conceptual framework and a sixth structural barrier that is not adequately captured by this model which focuses on policies and laws such as consent, autonomy, choice, and confidentiality. The findings have implications for social workers who are the largest social service profession in the U.S. and have a key role in addictions and mental health. As a profession with a social justice mission, it is critical that social workers advocate to reduce structural barriers for youth and meet their needs.