Young people's barriers to access mental health services

Currently 1 in 4 young people experiencing mental health problems receive mental health services. The limited research undertaken on inequalities in children and young people mental health service utilization has been restricted to young people awaiting or receiving mental health services. There is a lack of knowledge on those young people not accessing mental health services while experiencing mental health problems.

Two data sources, the Avon Longitudinal Study of Parents and Children (ALSPAC) and Next Steps (formally the Longitudinal Study of Young People in England), are well suited to explore the trajectories of onset, progression and management of mental health problems for those young people not accessing mental health services. Not only have these studies tracked the lives of thousands of children/young people growing up in England from birth/adolescent to young adulthood, but they have been or are in the process of being linked with the young people's health care records, thereby providing documentation of mental health service utilization. This sensitive data will be accessed through a secure link to protect anonymity of the participants involved.

Young People included in the ALSPAC cohort are more reluctant to participate in that year's survey if they experience mental health problems. This results in sporadic non-response and dropout. Other mental health studies have also found participant disinclination to partake when experiencing mental health problems and thus we assume young people have also been hesitant to complete the Next Step's survey when they experienced mental health problems. The missing data on these surveys is related to mental health status of the participants and if not controlled in statistical analyses would result in misrepresentation of the actual young people living with long-term mental health problems in British society. We will therefore employ Missing-Not-At-Random - MNAR methodology to take into account inadequacies in the data due to nonresponse. The analyses of these cohort datasets will enhance our understanding of the characteristics, COVID resilience, and receipt of informal support of young people with emotional mental health problems not receiving mental health services while minimizing bias caused by the missing data which is dependent on mental health status.

We have worked collaboratively with YoungMinds, a national mental health organization, to develop this project. Fiona Lacey, service design senior manager at YoungMinds, will train 4 young people to become advisors to the study. Under her supervision, these young people advisors will lead workshops with their peers to steer data analysis and interpret findings, thereby ensuring that the project is grounded in young people's experiences. Our relationship with YoungMinds will increase the reach of the study's findings beyond the academic community. Project-end activities will deliver findings to different academic and non-academic audiences, raise awareness of the subpopulation of young people with long-term mental health problems that do not receive mental health services and its relevance to mental health researchers, mental health care providers, charities and policy makers seeking to improve young people's access to mental health services.