Abstract/Summary

Studies have reported a higher prevalence of depression symptoms among adolescents in Saudi Arabia than in many other countries, though all have methodological limitations. This research set out to assess the prevalence of elevated depression symptoms using a more reliable method and to investigate some of the factors that may be associated with it, particularly barriers to seeking help. In Study 1, a systematic review of studies of the point prevalence of elevated depression symptoms in Saudi adolescents was conducted. In Study 2, the prevalence of elevated depression symptoms among adolescent females (aged 13-18 years) living in Unaizah, Saudi Arabia was investigated using the Mood and Feelings Questionnaire, a standardised self-report measure of depression symptoms. To explore barriers to seeking help semi-structured interviews were conducted with three groups of female participants. In Study 3, 16 of the girls who reported elevated symptoms were interviewed. In Study 4, ten of their female caregivers were interviewed. In Study 5 eight female school counsellors in Unaizah were interviewed. It was found that 48.2% of the girls reported elevated symptoms of depression, a high rate compared with many countries. The results of the semi-structured interviews suggested that there were four barriers to seeking help. These were: 1) the students’ depression symptoms were not being recognized by themselves, their caregivers, or the school counsellors; 2) the students had no one they could turn to directly for help, as they did not trust the school counsellor; 3) it was difficult for the caregivers and the counsellors to access specialist help because they required the permission of the father; 4) the caregivers had attitudes to mental illness that discouraged them from seeking help. Recommendations include improving the mental health literacy of adolescents, improving the training of school counsellors, and adopting a formal policy of confidentiality for school counsellors.