Barriers to Seeking Psychotherapy for Mental Health Problems in Adolescents: a mixed method study

Abstract

Given the large discrepancy between prevalence rates of mental disorders in adolescents and actual treatment rates, there is a need to understand what prevents this age group from seeking psychotherapy. We assessed the barriers to seeking psychotherapy in this age group, including their attitudes toward people with a mental disorder, using a convergent parallel mixed-methods design. Participants were 288 adolescents aged 12–21 years (M = 16.8 years, SD = 2.3; 37% identified as male, 63% as female, and 0% as nonbinary). Qualitative data were obtained with open-ended questions on barriers to initiating psychotherapy and attitudes toward people with a mental disorder. Barriers to seeking psychotherapy and information about psychotherapy were assessed with a questionnaire using a quantitative design. The qualitative assessment revealed as the main barriers fear of a negative interaction with a psychotherapist, fear of being confronted with their own emotions, self-stigma, and fear of public stigma. Further, lack of accessibility, lack of trust in the therapist, a desire for social distance from, and a negative attitude toward people with a mental disorder were associated with a decreased intention to initiate psychotherapy. Previous positive experience with a psychotherapist was a facilitator of seeking psychotherapy. We found gender differences, with higher desire for social distance and higher optimism bias scores as well as poorer mental health knowledge for participants identifying as male. Integrating results from both approaches results in further information for the improvement of prevention programs and interventions to lower barriers to seeking psychotherapy. Gender differences indicate a need for gender-role-specific interventions.