Table 1.

Literature summary

STUDYLOCATIONLEVEL OF EVIDENCENFINDINGS
Booth et al,1 2004AustraliaII: Qualitative study; purposive sampling (by sex, age, SES, and rural or urban location)810Three identified barriers to help-seeking: concerns about confidentiality, knowledge of services and discomfort with disclosing health concerns, and accessibility and characteristics of services
Rickwood et al,2 2007AustraliaII: Narrative review48 papersFor mental health problems, engaging in appropriate help is protective; school counselors, GPs, and youth workers are gatekeepers to mental health services for youth; nontraditional access points (eg, Internet) are increasingly useful to engage youth
Tylee et al,3 2007UK, SwitzerlandI: Systematic review90 studiesAssess effects of different service models of health care provision for youth in primary care or community health settings; research provides clear guidance on barriers for young people accessing primary care; evidence has not been translated into comprehensive design of youth-friendly services
Klein et al,4 1998USII: Telephone survey259, aged 14–19 yAssess adolescents’ use and knowledge of health services, perceived access, and barriers to access; adolescents identified physicians, health centres, and hospital clinics as available services; many did not know where to go for mental health services or reproductive health needs
James,5 2007AustraliaIII: Program review4Youth experiences of mental illness and treatment needs are different from those of adults; young people are in the best position to judge what is youth-friendly; barriers to accessing mental health services included concerns about confidentiality, lack of experience with the system, no GP, inadequate understanding of mental health issues
Santor et al,6 2007CanadaII: Non-randomized controlled trial1124 grade 7, 8, and 9 studentsImproving pathways to care depends on providing opportunities to seek help and actively promoting their use; benefits of a school-based intervention greatest among students with specific needs, such as high levels of distress
Hobcraft and Baker,7 2006Canada, GhanaIII: Interviews2Financial, logistical, and emotional challenges to accessing services; role of health care policy and resource allocation in protecting the rights of youth
Rosenfeld et al,8 1996USII: 4 focus groups20, aged 13–21 yPilot survey; urban adolescents wanted dignified, respectful treatment and to be listened to and taken seriously by primary care providers
Oberg et al,9 2002USIII: Narrative review112 studiesAccess to care is a socio-organizational complex of health care delivery and multiple covariable parameters; integrated community health care delivery models require collaboration among health care and other professionals
Brindis et al,10 2002USIII: ReviewNAAccess to preventive health services through annual visits to physicians increases adolescents’ knowledge and skills and improves their opportunities to assume responsibility for their own health and well-being
CIHI,11 2005CanadaI: Literature review133 studiesYouth with more assets report better health and higher self-worth and are less likely to engage in potentially harmful practices (eg, substance misuse)
Zachrisson et al,12 2006NorwayI: Population-based cross-sectional health survey11 154, aged 15–16 yHelp-seeking passes through several “filters,” each excluding some help-seekers; a minority of adolescents with mental health problems seek help; help-seeking in those with the highest symptom load is low; half the help-seekers achieved contact with GPs; few reached other services
Biddle et al,13 2004UKI: Cross-sectional survey3004, aged 16–24 yStrongest predictors of help-seeking are case severity and previous help-seeking; boys are less likely to seek help or confide than girls are
Black et al,14 2008USII: Convenience sample survey57Adolescents who experienced dating violence most often sought help from peers; when violence occurred in isolation, survivors were more likely to receive no support from others; male and female help-seeking differed
Kari et al,15 1997UKII: Survey347, aged 12–18 yBarriers to adolescents accessing primary care included stigma, service organization, and lack of knowledge
Deane et al,16 2007AustraliaI: Control group survey506 high school studentsLow rates of help-seeking and poor access to health care for adolescents are particular problems in rural locations; intervention resulted in increases in intention to seek professional health care; despite increases, intentions remained relatively low
Chandra and Minkovitz,17 2007USII: Purposive sample57 grade 8 studentsFive themes about mental health stigma: personal experience, personal knowledge, family conversations, peer conversations, and perceived social consequences of seeking help
Kang et al, 200518 and 200619AustraliaII: Systematic analysis of multiple service models77 papersSeven principles of better practice robust across all services and sectors: access facilitation, evidence-based practice, youth participation, collaboration, professional development, sustainability, and evaluation
Edwards et al,20 2007USII: Review of legislation and literatureNABuilding on assets ameliorates problematic behaviour and develops resiliency; school-based services have a vital role in implementing the Positive Youth Development model
Browne et al,21 2004Canada, South AfricaI: Literature review RCTs or quasi-experimental comparison group studies with qualitative studies added23 reviewsPrograms designed to develop protective factors through increased skill or competence are more effective than those aimed at reducing negative behaviour; effective services address individual needs and address the whole child, including clustered emotional behaviour problems; recommend collaborative service delivery with an intersectoral governance structure
Anderson-Butcher and Fink,22 2005USII: Purposive sample; survey and regression analysis149 youth program participantsInformal relationships and social norms developed in youth programs make a difference in the lives of youth
Butler Walker et al,23 2008CanadaIII: Report on a planning process involving health resource workersNAEstablishes frameworks for addressing community health issues from a community perspective; identifies key individuals and agencies, background information, goals, objective, strategies, activities, and indicators for each community health issue addressed
Bruce et al,24 2003CanadaII: Youth-designed survey, focus groups, program evaluation, and documents152, aged 15–24 yThree themes in the transition to adulthood: belonging and connectedness vs independence; value and need the support of adults,; and meaningful involvement with families, schools, and communities are significant builders of assets, skills, and resilience
  • CIHI—Canadian Institute for Health Information, NA—not applicable, RCT—randomized controlled trial, SES—socioeconomic status.