Adolescents Identify Modifiable Community-Level Barriers to Accessing Mental Health and Addiction Services in a Rural Canadian Town: A Survey Study

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors 1. The bibliography must be supported; 2. This questionnaire should be better described; 3. Results are too limited to the a rural community. A comparison with a non-rural group would have been interesting.      

 

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

First, I would like to thank you for the opportunity to read this work. I found this study interesting because it contributes to filling a gap in the literature concerning the barriers to accessing mental health services in high school students from a rural town. In addition, the findings have practical implications.

Below, I leave some comments and suggestions, hoping they improve the paper.

INTRODUCTION

This section could be improved by deepening the literature review on the most frequent mental health issues among adolescents. The authors could also have added literature on previous findings concerning the outcomes of mental health services for adolescents worldwide to highlight the importance of these services. In addition, it will be essential to add why studying the rural context is essential compared to the urban context. In other words, it is essential to highlight the specificities and challenges of mental health services in rural contexts compared to urban ones.

MATERIALS AND METHODS

Please confirm that Appendix 1 is available. Following the journal template, add it by the end of the manuscript, before the references section.

It is also essential to provide more information concerning the procedure, such as how the questionnaire was made available online, how the data was collected and how the ethical issues and confidentiality of the data were guaranteed. In addition, the information included in the informed consent and assent forms to the participants and tutors/parents of the participants (when applied).   

RESULTS

Figure 1 is very appellative. However, the text describing this figure lacks information. In other words, I was expected to see some statistics. I believe some statistics could also be added in Figure 1 to make it more evident from the readers’ perspective why the "lack of awareness of available resources" was in the first place.

DISCUSSION

This section could be deepened by discussing all barriers presented in Figure 1, at the individual and community level, and overall barriers.

CONCLUSIONS

The conclusions are not evident from the reading of the previous sections. I suggest developing this section and adding more conclusions from the present study. 

Comments on the Quality of English Language

 Minor editing of English language required.

Author Response

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Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

Although the study proposal is relevant to rural Canadian society and to improving adolescent mental health care, I am concerned about some limitations of the manuscript, in its current format, that should be improved for acceptance.

- It is proposed to limit the keywords to six.

- Reflect the most significant results in the summary.

- Limited theoretical framework. It should be expanded taking into account previous studies and the perceived barriers regarding mental health services in the adolescent population.

- In the results, no descriptive analyzes are shown, nor are there relational analyzes between both groups (group that has attended mental health services and those who have not attended.

- The sample is small.

- Indicate the ethical approval code.

 

Author Response

Please see attachment

Author Response File: Author Response.pdf

Round 2

Reviewer 3 Report

Comments and Suggestions for Authors

I would like, first of all, to thank the authors for improving the manuscript and continuing the development of the work. All changes included are correct. I encourage the authors to expand the theoretical framework in the future and to continue research in this regard.