Systematic review of barriers and facilitators to accessing and engaging with mental health care among at-risk young people

Asia Pac Psychiatry. 2016 Mar;8(1):3-22. doi: 10.1111/appy.12199. Epub 2015 Aug 3.


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 Aboriginal or Torres Strait Islander (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.

Keywords: adolescence; early intervention; mental health; populations at risk; young adult.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Adolescent
  • Australia
  • Health Services Accessibility*
  • Health Services Needs and Demand
  • Homeless Youth
  • Humans
  • Mental Health Services*
  • Native Hawaiian or Other Pacific Islander
  • Patient Participation*
  • Qualitative Research
  • Rural Population
  • Sexual and Gender Minorities
  • Substance-Related Disorders
  • Vulnerable Populations
  • Young Adult