Children’s Mental Health Distress and Barriers to Help-Seeking: Insights from the Tinkle Friend Chatline

Abstract

Background: Tinkle Friend is the national chatline providing support, advice, and information to primary school children in Singapore. Children’s help-seeking pathways are often mediated by parents, schools, or healthcare settings, but chatlines are an understudied avenue of support. Little is known qualitatively about children’s mental health concerns and help-seeking experiences that contributed to them seeking help on chatlines. Objective: The study aimed to explore via chatline data what contributed to children’s mental health distress and their experiences related to help-seeking from people around them. Methods: Fifty-seven (approximately 20%) mental health-related chats logged between March and December 2021 were randomly selected and analysed using thematic analysis. Chats shorter than 15 min were excluded. Study sample comprised children aged 8–13 years (M = 11.5 years). Results: Two themes were identified: sources of distress and barriers to help-seeking. Children’s distress mainly stemmed from harsh parenting and children experiencing collateral damage from parental conflict within the family, academic and behavioural expectations in school, and bullying and pursuing peer social acceptance. In response to distress, children were reluctant to seek help due to distrust, fear of rejection and stigma, parental invalidation, and perceiving adults and peers as unreliable sources of support. Conclusions: Child chatlines contain a valuable repository of children’s lived experiences. Findings extend prior research on help-seeking by identifying parental invalidation, and unreliable adult and peer support as novel barriers to help-seeking among children. Findings also affirm the importance of maintaining child chatlines as a viable pathway to support for children, especially among children who lack strong support networks.