“When you’re in the office, it means you managed to get somewhere”: perceptions of adolescents with anxiety or mood disorders of accessing primary care for mental health services

Abstract

In Ontario, the majority of children and youth with mental illnesses access primary care as their initial source of mental health services (Institute for Clinical Evaluative Sciences, 2017). Primary care can be an ideal setting for accessing mental health services to prevent symptoms from worsening (Cappelli & Leon, 2017). Adolescence is a time when young people experience several developmental changes and transitions, making them susceptible to mental illnesses (Government of Canada, 2011). Examining adolescents’ perceptions of access is critical to examining how primary care is accommodating their mental health needs (Cappelli & Leon, 2017). The primary purpose of this study was to explore the perceptions of adolescents, living in Hamilton, Ontario, with an anxiety or mood disorder, of accessing primary care for mental health services. Perceptions regarding the role of primary care nurses in facilitating access was also explored. Qualitative interpretive descriptive methods were utilized. Data collection included: demographic survey, semi-structured interviews, photo-elicitation project, field notes, and reflexive journaling. Analysis was guided by an access framework (Penchansky & Thomas, 1981) and ecological model (McLeroy et al., 1988). Adolescents ages 15 to 18 years (n=10) participated. Adolescents perceived access to primary care for mental health services as a difficult and complex process involving multiple stages including: feeling uncertain about their mental health concerns and if they required help, seeking informal support from parents and friends to initiate receiving help, and obtaining mental health services from primary care. Implications of this study include addressing adolescents’ developmental needs in care through implementing an individualized-approach and supporting development throughout emerging adulthood. Primary care practitioners must provide information to adolescents and parents about mental health concerns and services during routine interactions. Greater organizational support would enable primary care nurses to have an active role in delivering mental health services and providing comprehensive care.