Abstract/Summary

Anxiety and depressive disorders are the most common mental health disorders in adolescents. However, only a minority of those affected access evidence-based professional help. Understanding the reasons for not seeking or accessing professional help from the perspectives of young people is crucial to address this treatment gap. The aims of this thesis were to 1) identify the most common reasons that stop young people from seeking and accessing help (Paper 1), 2) explore barriers and facilitators to helpseeking/accessing among adolescents who met diagnostic criteria for anxiety and/or depressive disorders and were identified in a community (Paper 2), and 3) identify ways to reduce barriers to seeking/accessing treatment for anxiety and depressive disorders in adolescents (Papers 2 and 3). A multiple methods approach was chosen to fully address the complexity of the thesis aims. Findings identified a large number of barriers and facilitators that influence adolescents’ help-seeking behaviour. Notably, barriers and facilitators were identified at the level of adolescents, their support network, professional services and the broader context. The findings have clear implications for reducing barriers to adolescent mental health treatment. Firstly, mental health knowledge among young people and surrounding adults (parents and professionals) needs to improve. Brief and accurate identification tools, such as a set of 11 RCADS items developed in this thesis, have the potential to help various stakeholders identify adolescents with anxiety and/or depressive disorders in community settings. Secondly, adolescents’, parents’ and broader societal negative attitudes and views towards mental health and help-seeking need to be reduced. Finally, efforts need to be made to enable adolescents and their families to access evidence-based support. Future research should focus on developing developmentally appropriate interventions to improve treatment rates for anxiety and depressive disorders in adolescents. Including young people in each step of the research will be essential.