Systematic review of barriers and facilitators to accessing and engaging with mental health care among at‐risk young people
Open accessAbstract
Introduction: This study aims to review the literature on barriers and facilitators to accessing and engaging with mental health care among young people from potentially disadvantaged groups, including young people identified as A boriginal or T orres S trait I slander ( ATSI ); culturally and linguistically diverse ( CALD ); lesbian, gay, bisexual, transgender, queer, or intersex ( LGBTQI ); homeless; substance using; and youth residing in rural or remote areas. Methods: Fourteen databases were searched to identify qualitative and quantitative researches that examined barriers and/or facilitators to mental health care among the six groups of potentially disadvantaged young people. Results: Out of 62 studies identified, 3 were conducted with ATSI young people, 1 with CALD young people, 4 with LGBTQI young people, 14 with homeless young people, 24 with substance‐using young people, and 16 with young people residing in rural or remote areas. Findings generally confirmed barriers already established for all young people, but indicated that some may be heightened for young people in the six identified groups. Findings also pointed to both similarities and differences between these groups, suggesting that ATSI , CALD , LGBTQI , homeless, substance‐using, and rural young people have some similar needs with respect to not only mental health care, but also other needs likely to reflect their individual circumstances. Discussion: This systematic review highlights that young people from potentially disadvantaged groups have distinct needs that must be recognized to improve their experiences with mental health care. Future research of good methodological quality with young people is needed to increase accessibility of, and engagement with, mental health care.
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Several barriers including stigma, time, and financial costs prevent access to, and engagement with, evidence-based care.
“While clinician-led cognitive behavior therapy effectively improves IU, several barriers including stigma, time, and financial costs prevent access to, and engagement with, evidence-based care (Brown, Rice, Rickwood, & Parker, 2016; van den Heuvel, Barozzino, Milligan, Ford-Jones, & Freeman, 2016), with two-thirds of diagnosed youth not receiving the help they need (Merikangas et al., 2011).”
From A single session online training reduces intolerance of uncertainty and improves mental health in emerging adults. (2025) · cites this paper as Brown et al., 2016
The review’s “Barriers and facilitators common across target groups” section (page not provided) identifies stigma, treatment cost, and waiting lists as barriers to accessing mental health services. Its “Barriers to engaging with services” section identifies lack of money, but does not establish stigma or time costs as barriers to engagement; the review also does not specify that the affected care is evidence-based. (LLM, conf=0.86)
Experimental — accuracy not yet measuredFinancial and temporal barriers often prevent youth from accessing mental health care.
“Given the financial and temporal barriers that often prevent youth from accessing mental health care (Brown et al., 2016)”
From A single session online training reduces intolerance of uncertainty and improves mental health in emerging adults. (2025) · cites this paper as Brown et al., 2016
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- Authors
- Brown, A., Rice, S. M., Rickwood, D. J., & Parker, A. G.
- Affiliations
- The University of Melbourne (AU)
- Corresponding author
- Parker, Alexandra G.
- Venue
- Asia-Pacific Psychiatry
- Publisher
- Wiley
- Published
- 2015-08-03
- Volume
- 8
- Issue
- 1
- Pages
- 3-22
- ISSN
- 1758-5864 (ISSN-L)
- 1758-5872
- OpenAlex
- W1502382971
- Cited by
- 274
- References
- 6
- Citations by year
- 2026: 23 · 2025: 37 · 2024: 30 · 2023: 26 · 2022: 28 · 2021: 31 · 2020: 74 · 2019: 5 · 2018: 9 · 2017: 5 · 2016: 5 · 2015: 1
- FWCI
- 1.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Asia-Pacific Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- University of Canberra Research Portal (submittedVersion)
- Funders
- headspace
- National Youth Mental Health Foundation
- Department of Health
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- barriers to mental health care, at-risk youth, Aboriginal and Torres Strait Islander youth, homeless youth, disadvantaged youth, access to mental health care
- MeSH terms
- Sexual and Gender Minorities, Adolescent, Australia, Health Services Accessibility, Health Services Needs and Demand, Humans, Mental Health Services, Patient Participation, Rural Population, Homeless Youth, Substance-Related Disorders, Vulnerable Populations, Qualitative Research, Native Hawaiian or Other Pacific Islander, Young Adult
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