From the Guidelines
The recommended approach to accessing mental health care for adolescents involves a multi-step process starting with an initial assessment by a primary care provider, as outlined in the guidelines for adolescent depression in primary care 1.
Key Steps in Accessing Mental Health Care
- Parents or teens should first consult with their pediatrician or family doctor who can conduct preliminary screenings and provide referrals to mental health specialists if needed.
- These specialists may include child and adolescent psychiatrists, psychologists, or licensed therapists who specialize in adolescent care.
- Annual universal screening of youth 12 and over at health maintenance visits is recommended, as well as the identification of depression in youth who are at high risk 1.
- Early intervention is crucial, so parents should watch for warning signs such as persistent mood changes, declining academic performance, withdrawal from friends and activities, or expressions of hopelessness.
- Treatment typically involves a combination of therapy and, in some cases, medication, with family involvement being essential throughout the treatment process.
- School counselors can also serve as valuable resources for initial support and referrals.
- Insurance coverage should be verified before beginning treatment, and community mental health centers or university training clinics may offer more affordable options for families with financial constraints.
Importance of Confidentiality and Accessibility
- Confidentiality is key for addressing many types of preventable problems, as fear of disclosure, diagnosis, and treatment may cause adolescents to delay or avoid needed care 1.
- Health services for adolescents must be recognizable, convenient, and affordable, with a basic level of service provided to all youth 1.
- Services should cater to developmental, cultural, ethnic, and social diversity among adolescents, with coordination of comprehensive services being ensured 1.
Reducing Suicide Risk
- For adolescents who seem to be at moderate or high risk of suicide or have attempted suicide, arrangements for immediate mental health professional evaluation should be made during the office visit 1.
- Intervention should be tailored to the adolescent’s needs, with hospitalization being considered for those at high risk.
- Vigorous treatment of the underlying psychiatric disorder is important in decreasing short-term and long-term risk of suicide, and safety planning may help guide a patient and their family in what steps to take in moments of distress to ensure patient safety 1.
From the Research
Access to Mental Health Care for Adolescents
The recommended approach to accessing mental health care for adolescents involves addressing both demand and supply-side barriers to ensure adequate evidence-based interventions. Key considerations include:
- Interventions delivered in school settings and using digital health technologies can improve access to mental health care for adolescents, especially in the post-pandemic world 2.
- Emphasis on equity is crucial when designing adolescent mental health programs to reach out to those who need services the most 2.
- Old myths, treatments, and policies are no longer tolerated, and there is an opportunity to develop and implement evidence-based interventions, modern training programs, and effective policies 3.
Barriers to Accessing Mental Health Care
Several barriers restrict adolescents' access to mental health care, including:
- Low help-seeking rates, with only a minority of adolescents reporting symptoms above case-levels on screenings for mental health seeking and receiving help from specialist health services 4.
- Stigma as a barrier to engagement, with adolescents requiring autonomy to engage in mental health treatment 5.
- Systemic influences as both barriers and facilitators to engagement, highlighting the need for interventions that address adolescents' ability to be autonomous 5.
Improving Access to Mental Health Care
To improve access to mental health care for adolescents:
- Health services should prioritize the development of empathic communication skills by health professionals working with adolescents with mental health problems 6.
- Interventions should address mental health literacy as a crucial factor in the decision to engage in mental health treatment 5.
- Quality of the therapeutic relationship is integral to engagement, and adolescents require a choice in their treatment to feel invested in the process 5.