Life Challenges and Barriers to Help Seeking: Adolescents’ and Young Adults’ Voices of Mental Health
Abstract
:1. Introduction
1.1. Previous Research on the Perception of Youth Mental Health and Help-Seeking Behaviour
1.2. Research Questions
- What skills among adolescents and young adults can be identified as important to be able to deal effectively with the demands and challenges of everyday life?
- What are the needs and barriers to help-seeking among adolescents and young adults regarding mental health problems?
2. Materials and Methods
2.1. Data and Participants
2.2. Procedure and Interview Guide
2.3. Data Analysis
3. Results
3.1. Life Challenges
3.1.1. Sources of Mental Health Problems
You’re too young to know… well “I want to be a carpenter, I want to be a doctor” and such. So you are left alone, sort of. You do not know where to go because you have to take certain steps to get to certain places. And then it’s kind of hard to decide, you do not know.(Municipality B, boy)
And I think maybe you should not paint a school with negativity but still present that if you work in these professions it will be like this… well it will not be that you work seven to five every single day and have weekends free and things like that… in healthcare. Now I also understood it when I applied for the program but no one told me about conditions you have during work, sometimes you do not even have time to eat lunch and everything like that. They paint everything that is so good and then this bad, you get it like a slap in the face, because no one tells you about it. Because it’s criticism like ... And then you get these bad things for free, you get to learn it yourself as well.(Municipality B, girl)
I think there must be a changed picture of what life after school really is, when you are in school. To find out all that yourself afterwards, it becomes very difficult for very many depending on what kind of support you have or if you have parents who support you or something like that. Because already in high school, they say that "now all the responsibility lies with you" and then you turn 18 and then you are an adult even though you are not treated like an adult.(Municipality A, girl)
“So there’s a lot you have to live up to, like… what they post, that this is what life should look like. If you do not have this instagram life then life is no good”.(Municipality B, girl)
A classic example is this… well after the test… that many people like to walk around and ask "what score did you get?" and then you feel pressure if you did not reach the same level or so. And that in turn can lead you to feeling unsuccessful and then you skip the next test instead.(Municipality C, girl)
That’s how it was for me and I got depressed from a very early age so there was no one… I did not understand and there was no one around me who saw it either and I think I pushed myself quite far... for me it took quite a long time to understand that it was a state of disability in a way that you could get well from it and that it was not something that was going to last forever.(Municipality A, girl)
I actually believe that... you kind of have to see the real world, the more you get into it… so you do not try to change or remove that which is experienced as difficult, because you encounter some hurdles.(Municipality D, boy)
3.1.2. Managing Relationships
So I think love relationships are after all… when it becomes relevant, it takes up a very, very large part of one’s thoughts and person in general, I think. And to just be able to go to someone and ask “am I doing the right thing? Am I reasonable? ” such things, would probably have been very… a greater security I think than to deal with all this myself.(Municipality A, boy)
My mental state right now is because everyone comes to me to talk and I’m the one who likes to be quiet and not talk so much as well. So it would be nice to have tools to like....(Municipality C, girl)
You are expected to be masculine, to be rock hard, you should endure everything like this. If you say something like “I’m not feeling well today, it’s not going to work today. My psyche destroys everything ”. It is not an option for them, then it is like “pack your bags and don’t come back no more”. So you must never lower your guard or what to say and calm it down. It is the one who is most masculine who dictates the rules.(Municipality B, boy)
All my guy friends from primary school have told me that they experience situations of mental health problems. And it’s a bit like "yes but why don’t you talk about it" and "no we never talk about that". So guys do not talk about feelings like we girls do.(Municipality D, girl)
3.1.3. An Accepted Way to Express Mental Health Problems
Students could sit in the classroom and say “but I can not focus because I have ADHD” and scream and have fun, which made it harder for me who actually had the diagnosis… because I know the people who sat and screamed did not have it… it was a way to blame someone else or scream or get yes… it was like, it was not true, which made it very difficult for me and the other people in the class to be taken seriously. And the same with anxiety and depression, it unfortunately becomes difficult to be taken seriously because it is based on these stereotypes that exist around it.(Municipality A, girl)
“But now... it’s a little more mainstream to have mental health problems”.(Municipality A, girl)
It depends on the way you seek attention. If I go out and shout that I feel really bad, then it’s like a cry for help but then I do not do it the right way I do not think”.(Municipality D, boy)
“I think the difference is a bit, for me anyway, that what you often hear is "come on, pull yourself up" and they can do it… there is a difference as well. It’s not as simple as that”.(Municipality A, girl)
3.2. The Need for Present Adults
3.2.1. A Need to Be Seen and Heard
Of course you understand that not everything is a bed of roses, but sometimes you have to be confirmed that if you do not seize it now, it can get worse. So you can go from having just a bad day, then there will be several bad days and you only hear that everyone has bad days sometimes. So sometimes you need confirmation for… and understanding as well.(Municipality B, girl)
I usually feel that way when parents ask the same question every day, then I feel that it becomes monotonous because then it’s the same answer every day as well. So there will be no progress. So they will not find out so much more than they already know. Yes, but "how was school today?" It was fine ”. Yes, but they do not ask any more questions "well what did you do?" "The ordinary".(Municipality A, girl)
We are supposed to learn from adults, that they have more experience in life and they know what is right and wrong, but then, they must also learn from us. It is we who live in the youth now.(Municipality D, girl)
I would also say diminishing… that people say "pull yourself up, bite the bullet” or “everyone has bad days and hard times" and then you sit there and feel stupid for feeling the way you do when it may not be quite the same as for those who do not feel mentally ill. But then you feel stupid or yes, you are kind of diminished and I do not think people think about it. But it reflects quite hard on oneself. And then maybe you start telling yourself that "I’m just lying, I’m totally weird in the head”. So it will be like a huge mistake, which is a great pity because maybe you should not have to hear that.(Municipality A, girl)
So I have a psychologist that I also go to at BUP [child and adolescent psychiatry] but I don’t really feel… so we have not really got that connection or what to say, that I feel I can talk to her. Because it feels a little, for me it feels very well… so… that there must always be a solution or a cause and you always have to go into all these causes and for me it just feels like… so, I would rather move forward if you say.(Municipality A, girl)
3.2.2. Need for Accessibility
“It feels like they have to come and make some contact with you… they may be able to ask like everyone else, of course it is difficult but then ask how they really feel …”.(Municipality A, boy)
“It is still not normalized, it is just made up”.(Municipality C, girl)
“That you yourself have to reach out a hand when it’s me who needs the help”.(Municipality B, girl)
I also remember that the school social worker who were available, they were maybe there once a week, every other month as well so there was no opportunity to go and talk to them. They sat there at school for three hours one day a week and I don’t really know how it would be prioritized who would be allowed to go and talk to them.(Municipality A, girl)
I think this is very important for school social workers… at [the school] where I go, where it was changed… so we could have the same school social worker for two months tops. And then there are those who have problems and may want to go and talk to a counselor… then they never have the time to develop a trust in this person. So I think it is very important that you have this adult… that you can talk to and you can have the stability over time.(Municipality D, boy)
4. Discussion
4.1. Results Discussion
4.1.1. Life Challenges as Identified by Young Adults
4.1.2. Barriers to Help-Seeking Behaviour
4.2. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Meaning-Carry Unit | Condensed Meaning-Carry Unit | Code | Sub-Category | Category |
---|---|---|---|---|
“A classic example is this… well after the test… that many people like to walk around and ask "what score did you get?" and then you feel pressure if you did not reach the same level or so. And that in turn can lead you to feeling unsuccessful and then you skip the next test instead…” | You feel pressure and unsuccessful if you did not perform as well as your classmates | Constant comparisons | Sources of mental health problems | Life challenges |
“That it’s supposed to be good all the time and look nice… and that you can end up feeling bad if you don’t live up to that. I think that social media contributes to mental ill-health” | Social media creates expectations that everything in life is supposed to be good and nice all the time | Constant comparisons | Sources of mental health problems | Life challenges |
”Because I can see friends that I love, who I wish all the success in the world… and catch myself and almost… be mad over their success and that they are experiencing fun things… ‘okay, so everybody else is doing great, why is everybody leaving me?” like that. And then it becomes very selfish, which I am well aware of and then you become mad at yourself… | Wanting your friends to succeed but at the same time feeling jealous and end up feeling ashamed for being selfish | Constant comparisons | Sources of mental health problems | Life challenges |
Sub-categories | Categories | |
Life challenges | The need for present adults | |
Sources of mental health problems | A need to be seen and heard | |
Managing relationships | A need for increased availability | |
An accepted way to express mental health problems | - |
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Hellström, L.; Beckman, L. Life Challenges and Barriers to Help Seeking: Adolescents’ and Young Adults’ Voices of Mental Health. Int. J. Environ. Res. Public Health 2021, 18, 13101. https://doi.org/10.3390/ijerph182413101
Hellström L, Beckman L. Life Challenges and Barriers to Help Seeking: Adolescents’ and Young Adults’ Voices of Mental Health. International Journal of Environmental Research and Public Health. 2021; 18(24):13101. https://doi.org/10.3390/ijerph182413101
Chicago/Turabian StyleHellström, Lisa, and Linda Beckman. 2021. "Life Challenges and Barriers to Help Seeking: Adolescents’ and Young Adults’ Voices of Mental Health" International Journal of Environmental Research and Public Health 18, no. 24: 13101. https://doi.org/10.3390/ijerph182413101