Roulston Chantelle A, Ahuvia Isaac, Chen Sharon, Fassler Julia, Fox Kathryn, Schleider Jessica L
Department of Medical Social Sciences, Northwestern University, Chicago, Illinois, USA.
Department of Psychology, Stony Brook University, Stony Brook, New York, USA.
J Res Adolesc. 2025 Mar;35(1):e70013. doi: 10.1111/jora.70013.
Depression is the leading cause of disability among adolescents. Fewer than 50% of youth with depression access mental healthcare services. Leveraging a mixed-methods approach, this pre-registered study characterized youths' self-reported barriers to accessing mental healthcare in a socio-demographically diverse sample of 123 United States adolescents (ages 13-16, identifying as Asian (n = 19), Hispanic (n = 23), Black (n = 7), White (n = 65), or other race (n = 9); man (n = 9), woman (n = 58), or gender minority (n = 56); heterosexual (n = 19) or sexual orientation minority (n = 104)). All participants were experiencing elevated depression symptoms (Patient Health Questionnaire-2 score of ≥2) and endorsed wanting mental health support but being unable to access it. We asked participants an open-ended question gauging perceived barriers to accessing care ("what has kept you from getting support when you wanted it?"), and a binary item gauging perceived current need for mental health support ("right now, do you feel that you need support for emotional or mental health problems?"). Via thematic analysis of responses to the perceived barriers question, we identified a total of 13 categories of barriers. Across all participants, 42.48% (n = 52) endorsed family-related barriers and 31.71% (n = 39) endorsed financerelated concerns. We conducted Chi-square analyses, examining rates of endorsing specific barriers as a function of (a) perceived current support need and (b) demographic variables (e.g. race/ethnicity, gender). In the current study, all adolescents endorsed similar categories of treatment access barriers, regardless of race/ethnicity, gender, sexual orientation, and level of depression. Implications for increasing mental healthcare access for adolescents with elevated depression symptoms are discussed.
抑郁症是青少年致残的主要原因。患有抑郁症的青少年中，只有不到50%的人能获得心理健康护理服务。本项预先注册的研究采用混合方法，在123名美国青少年（年龄在13 - 16岁之间，分别为亚裔（n = 19）、西班牙裔（n = 23）、黑人（n = 7）、白人（n = 65）或其他种族（n = 9）；男性（n = 9）、女性（n = 58）或性少数群体（n = 56）；异性恋（n = 19）或性取向少数群体（n = 104））这一社会人口统计学特征多样的样本中，对青少年自我报告的获得心理健康护理的障碍进行了特征描述。所有参与者的抑郁症状均有所加重（患者健康问卷 - 2得分≥2），并表示希望获得心理健康支持，但无法获得。我们向参与者提出了一个开放式问题，以衡量他们认为获得护理的障碍（“当你需要支持时，是什么阻止了你获得支持？”），以及一个二元项目，以衡量他们目前对心理健康支持的需求（“现在，你觉得你需要针对情绪或心理健康问题的支持吗？”）。通过对关于感知障碍问题的回答进行主题分析，我们总共确定了13类障碍。在所有参与者中，42.48%（n = 52）表示存在与家庭相关的障碍，31.71%（n = 39）表示存在与资金相关的担忧。我们进行了卡方分析，检验了认可特定障碍的比例与（a）当前感知的支持需求以及（b）人口统计学变量（如种族/族裔、性别）之间的关系。在本研究中，所有青少年认可的治疗获取障碍类别相似，无论种族/族裔、性别、性取向和抑郁程度如何。本文讨论了增加抑郁症状加重的青少年获得心理健康护理机会的意义。
