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YOUNG PEOPLE ACCESS TO MENTAL HEALTH SERVICES

Student Name

Institution Affiliation

Couse

Moduleᵔ Code

Professor’sᵔ Name

Date
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TABLE OF CONTENTS

1. RESEARCH QUESTION..........................................................................................................................3

2. INTRODUCTION...................................................................................................................................3

3. BACKGROUND.....................................................................................................................................4

4. RATIONALE..........................................................................................................................................5

5. AIM AND OBJECTIVES..........................................................................................................................6

6. METHODOLOGY...................................................................................................................................7

5.1 Literatureᵔ Searchᵔ Strategy.................................................................................................................8

5.1.1 Keywords..................................................................................................................................10

5.1.2 Inclusion andᵔ exclusion criteria.................................................................................................11

7. ETHICAL CONSIDERATIONS................................................................................................................11

7. TIMEFRAME TABLE............................................................................................................................16

8. REFERENCES......................................................................................................................................17
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YOUNG PEOPLE ACCESS TO MENTAL HEALTH SERVICES

1. RESEARCH QUESTION

What areᵔ theᵔ barriersᵔ andᵔ facilitatorsᵔ forᵔ young peopleᵔ agedᵔ 16-25 yearsᵔ in theᵔ UK to accessᵔ

appropriateᵔ mentalᵔ healthᵔ services?

PICO forᵔ theᵔ researchᵔ question:

Population: young peopleᵔ agedᵔ 16-25 years

Intervention: Barriersᵔ to accessᵔ to appropriateᵔ mentalᵔ healthᵔ services

Context: within theᵔ UK

Outcomes: Accessᵔ to appropriateᵔ mentalᵔ healthᵔ servicesᵔ (Dukeᵔ Universityᵔ, 2019)

2. INTRODUCTION

Mentalᵔ healthᵔ servicesᵔ referᵔ to therapeuticᵔ, rehabilitativeᵔ, andᵔ diagnostic servicesᵔ appliedᵔ

to treat mentalᵔ andᵔ emotionalᵔ illnesses. Someᵔ cognitiveᵔ orᵔ emotionalᵔ diseasesᵔ ariseᵔ from

substanceᵔ abuse. Lack of accessᵔ to mentalᵔ healthᵔ servicesᵔ leadsᵔ to chronic conditionsᵔ suchᵔ asᵔ

depression. Depression isᵔ among theᵔ leading sourcesᵔ of suffering andᵔ impairment among young

individualsᵔ in theᵔ UK. Theᵔ situation isᵔ consideredᵔ a significant risk factorᵔ forᵔ suicideᵔ andᵔ youthᵔ

indulgenceᵔ in drug abuseᵔ (Millerᵔ andᵔ Campoᵔ, 2021). Many young peopleᵔ haveᵔ lost controlᵔ of

theirᵔ livesᵔ dueᵔ to mentalᵔ illnessesᵔ sinceᵔ they do not seek accessᵔ to appropriateᵔ mentalᵔ healthᵔ

services. Thusᵔ, lack of accessᵔ to mentalᵔ healthᵔ servicesᵔ leading to theᵔ development of associatedᵔ

diseasesᵔ dueᵔ to stressᵔ andᵔ badᵔ episodesᵔ in lifeᵔ by young individualsᵔ isᵔ a significant threat to

public healthᵔ outcomesᵔ andᵔ diminishesᵔ theᵔ quality of individualᵔ life. Unfortunately,ᵔ, many young

peopleᵔ in theᵔ UK lack accessᵔ to orᵔ failᵔ to seek mentalᵔ healthᵔ servicesᵔ (Rodez et al.ᵔ, 2021).

According to Millerᵔ andᵔ Campo (2021)ᵔ, theᵔ numberᵔ of young peopleᵔ in needᵔ of mentalᵔ healthᵔ

servicesᵔ increasesᵔ, andᵔ moreᵔ information isᵔ requiredᵔ in theᵔ public domain to enhanceᵔ access.
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Thisᵔ researchᵔ paperᵔ aimsᵔ to exploreᵔ theᵔ known information about theᵔ barriersᵔ andᵔ

facilitatorsᵔ of young peopleᵔ accessing appropriateᵔ mentalᵔ healthᵔ servicesᵔ within theᵔ UK from theᵔ

availableᵔ literatureᵔ, generateᵔ dataᵔ, andᵔ giveᵔ an overview. Theᵔ paperᵔ consistsᵔ of theᵔ backgroundᵔ

andᵔ theᵔ rationaleᵔ sectionsᵔ, including conductedᵔ studiesᵔ andᵔ theᵔ statisticsᵔ relatedᵔ to accessᵔ to

mentalᵔ healthᵔ services. In additionᵔ, theᵔ articleᵔ containsᵔ otherᵔ a includesᵔ theᵔ aim andᵔ objectivesᵔ of

theᵔ researchᵔ andᵔ a proposedᵔ methodology forᵔ researchᵔ towardᵔ accessᵔ to mentalᵔ healthᵔ services.

Ethicalᵔ considerationsᵔ haveᵔ also get includedᵔ in theᵔ paper. Theᵔ backgroundᵔ information

containedᵔ in theᵔ articleᵔ concernsᵔ theᵔ young peopleᵔ in theᵔ UK.

3. BACKGROUND

Young peopleᵔ in theᵔ UK haveᵔ been diagnosedᵔ withᵔ theᵔ highest prevalenceᵔ of mentalᵔ

illnessesᵔ acrossᵔ allᵔ ageᵔ groups. Young individualsᵔ also bearᵔ a disproportionateᵔ burden of theᵔ

diseasesᵔ associatedᵔ withᵔ mentalᵔ disordersᵔ, yet theirᵔ accessᵔ to mentalᵔ healthᵔ servicesᵔ isᵔ lowerᵔ than

theᵔ rest ageᵔ groupsᵔ (Pitchforthᵔ et al.ᵔ, 2019). Theᵔ higherᵔ prevalenceᵔ of mentalᵔ illnessᵔ demonstratesᵔ

theᵔ direᵔ needᵔ forᵔ mentalᵔ healthᵔ services. Theᵔ poorᵔ accessᵔ to mentalᵔ healthᵔ servicesᵔ isᵔ a threat to

public healthᵔ outcomesᵔ sinceᵔ theᵔ quality of lifeᵔ getsᵔ damagedᵔ dueᵔ to a lack of accessᵔ to theᵔ

appropriateᵔ healthᵔ servicesᵔ (Pitchforthᵔ et al.ᵔ, 2019). Young peopleᵔ needᵔ to understandᵔ theᵔ

importanceᵔ of mentalᵔ healthᵔ servicesᵔ to changeᵔ theirᵔ attitudesᵔ towardsᵔ seeking theᵔ right

interventions.

Young peopleᵔ needᵔ accessᵔ to appropriateᵔ mentalᵔ healthᵔ servicesᵔ dueᵔ to theᵔ development

of associatedᵔ illnessesᵔ suchᵔ asᵔ depression. Depression among young peopleᵔ isᵔ a severeᵔ public

healthᵔ issueᵔ whoseᵔ problemsᵔ cut acrossᵔ theᵔ globeᵔ (Petkari andᵔ Ortiz-Tallo 2018). Depression

among young peopleᵔ isᵔ highly prevalent in developedᵔ countriesᵔ, including theᵔ UK. Millerᵔ andᵔ
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Campo (2021) recordᵔ that depression isᵔ theᵔ secondᵔ leading courseᵔ of mortality among young

peopleᵔ in England. Depression affectsᵔ young people'sᵔ development of stressᵔ, affecting theirᵔ

feelingsᵔ, making them sadᵔ, irritableᵔ, andᵔ a senseᵔ of emptinessᵔ, accompaniedᵔ by cognitiveᵔ

changesᵔ that can prolong andᵔ affect theirᵔ functioning (Pappa et al.ᵔ, 2021). Theᵔ Officeᵔ forᵔ

Nationalᵔ Statisticsᵔ in Britain reportsᵔ that 21% of young adultsᵔ expressedᵔ development of

depression in 2021 (Petkari andᵔ Ortiz-Tallo 2018). Theᵔ percentageᵔ increasedᵔ from theᵔ previousᵔ

statisticsᵔ in 2020ᵔ, whereᵔ theᵔ condition'sᵔ prevalenceᵔ wasᵔ 19%. Howeverᵔ, theᵔ spreadᵔ of depression

doubledᵔ during theᵔ outbreak of theᵔ covid-19 pandemic. Theᵔ previousᵔ recordsᵔ beforeᵔ theᵔ

pandemic wereᵔ 10% (Achdutᵔ, andᵔ Refaeliᵔ, 2020). Thereforeᵔ, thereᵔ isᵔ an urgent needᵔ to

understandᵔ theᵔ reasonsᵔ forᵔ spreading depression among young people. Understanding theᵔ leading

causesᵔ of depression among theᵔ young populationsᵔ willᵔ show whetherᵔ they haveᵔ easy accessᵔ to

mentalᵔ healthᵔ servicesᵔ (Panter‐Brick et al.ᵔ, 2018). Theᵔ rising numbersᵔ in theᵔ prevalenceᵔ of

depression indicateᵔ that young peopleᵔ lack accessᵔ to mentalᵔ healthᵔ services.

Young peopleᵔ needᵔ accessᵔ to mentalᵔ healthᵔ servicesᵔ to copeᵔ withᵔ theᵔ rising economic

crisis. Theᵔ inequality in theᵔ economic determinantsᵔ hasᵔ a significant impact on mentalᵔ health.

Theᵔ riseᵔ of externalᵔ factorsᵔ likeᵔ theᵔ Covid-19 pandemic can leadᵔ to inflation andᵔ fluctuation in

theᵔ country'sᵔ economy (Achdutᵔ, andᵔ Refaeliᵔ, 2020). Theᵔ pandemic ledᵔ to increasedᵔ

unemployment ratesᵔ andᵔ a lack of regularᵔ incomeᵔ asᵔ many firmsᵔ hadᵔ to terminateᵔ many people'sᵔ

jobs. Asᵔ a resultᵔ, theᵔ numberᵔ of joblessᵔ young peopleᵔ on theᵔ streetsᵔ increasesᵔ, andᵔ many indulgeᵔ

in drug andᵔ alcoholᵔ abuse.

4. RATIONALE

Many young peopleᵔ sufferᵔ from curableᵔ formsᵔ of mentalᵔ healthᵔ conditionsᵔ likeᵔ depression

dueᵔ to a lack of accessᵔ to mentalᵔ healthᵔ services. Forᵔ instanceᵔ, depression isᵔ a highly prevalent
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mentalᵔ healthᵔ problemᵔ, withᵔ projectionsᵔ showing that it affectsᵔ up to 2% of theᵔ population in

high-incomeᵔ nationsᵔ, including theᵔ UKᵔ, dueᵔ to failureᵔ to seek mentalᵔ healthᵔ servicesᵔ (Panter‐

Brick et al.ᵔ, 2018). Theᵔ prevalenceᵔ of mentalᵔ disordersᵔ isᵔ higherᵔ among young peopleᵔ agedᵔ

between 16 andᵔ 25 years. Suchᵔ an increasedᵔ susceptibility of young peopleᵔ coupledᵔ withᵔ theᵔ

reluctanceᵔ to seek out specialisedᵔ help makesᵔ theseᵔ young onesᵔ below theᵔ ageᵔ of 25

developmentalᵔ conditionsᵔ that affect theirᵔ vocationalᵔ, educationalᵔ, andᵔ socialᵔ outcomesᵔ andᵔ otherᵔ

adverseᵔ long-term repercussions. Thusᵔ, understanding barriersᵔ affecting accessᵔ to mentalᵔ healthᵔ

servicesᵔ by young personsᵔ isᵔ criticalᵔ to improving theirᵔ quality of lifeᵔ andᵔ public healthᵔ outcomesᵔ

(Mindᵔ 2021). Thereᵔ isᵔ a needᵔ to identify why young peopleᵔ areᵔ theᵔ least likely to seek help andᵔ

exploreᵔ relevant mentalᵔ healthᵔ services.

Someᵔ barriersᵔ to seeking help from mentalᵔ healthᵔ servicesᵔ includeᵔ concernsᵔ about trust

andᵔ confidentialityᵔ, preferenceᵔ forᵔ informalᵔ sourcesᵔ of assistanceᵔ, stigmaᵔ, andᵔ problemsᵔ in

accessing mentalᵔ healthᵔ support (Fordᵔ, John andᵔ Gunnellᵔ, 2021). According to literatureᵔ reviewsᵔ

on mentalᵔ healthᵔ in theᵔ UKᵔ, only a few haveᵔ concentratedᵔ on cognitiveᵔ health-seeking

behavioursᵔ andᵔ barriersᵔ facing young peopleᵔ accessing mentalᵔ healthᵔ servicesᵔ (Matthewsᵔ et al.ᵔ,

2019). Theᵔ ageᵔ of 16 to 25 representsᵔ a criticalᵔ group forᵔ study sinceᵔ it isᵔ usually theᵔ

transitioning stageᵔ into adulthoodᵔ during criticalᵔ decisionsᵔ regarding careerᵔ, intimateᵔ relationsᵔ,

andᵔ education. Thisᵔ study focusedᵔ on thisᵔ ageᵔ group sinceᵔ it encompassesᵔ theᵔ widerᵔ populationᵔ,

including thoseᵔ in education andᵔ past education stage.

5. AIM AND OBJECTIVES

Thisᵔ study aimsᵔ to analyseᵔ what isᵔ known about theᵔ barriersᵔ forᵔ young peopleᵔ to accessᵔ

mentalᵔ healthᵔ servicesᵔ that can prevent suffering among them. Theᵔ researchᵔ willᵔ focusᵔ on theᵔ

following objectivesᵔ to achieveᵔ itsᵔ aim:

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1. To exploreᵔ young people’sᵔ mentalᵔ healthᵔ statusᵔ within theᵔ Unitedᵔ Kingdom

2. To exploreᵔ accessᵔ to mentalᵔ healthᵔ servicesᵔ in theᵔ UK

3. To analyseᵔ young people’sᵔ barriersᵔ to mentalᵔ healthᵔ services

4. Identify what can get doneᵔ to enhanceᵔ young people’sᵔ accessᵔ to mentalᵔ healthᵔ

servicesᵔ in theᵔ UK.

Theᵔ researchᵔ intendsᵔ to present the current knowledgeᵔ and information known about

young people and the barriersᵔ to accessing mental health services. Critically analysing current

knowledgeᵔ about student suicideᵔ willᵔ beᵔ relevant to guideᵔ informedᵔ decisions making andᵔ

prevent student suicide.

6. METHODOLOGY
The study will utilise secondary researchᵔ in theᵔ form of a literatureᵔ review asᵔ theᵔ
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methodology forᵔ research. Thereᵔ areᵔ variousᵔ typesᵔ of literatureᵔ reviewsᵔ where; oneᵔ isᵔ a narrativeᵔ

review. Narrativeᵔ reviewsᵔ provideᵔ a comprehensiveᵔ overview by placing theᵔ information into

perspectivesᵔ andᵔ providing an appropriateᵔ description of theᵔ development of a problem to offerᵔ a

solution (Craneᵔ et al.ᵔ, 2019). Theᵔ secondary researchᵔ forᵔ theᵔ narrativeᵔ review of literatureᵔ usesᵔ

existing information from variousᵔ sourcesᵔ collectedᵔ andᵔ producedᵔ by others. Secondary researchᵔ

isᵔ lessᵔ costly andᵔ easily accessibleᵔ, making it relevant when working within theᵔ given timeframe.

In additionᵔ, extensiveᵔ researchᵔ concerning youthᵔ accessᵔ to mentalᵔ healthᵔ servicesᵔ hasᵔ got

conductedᵔ, resulting in a vast amount of information that can get gatheredᵔ about student suicideᵔ

(Al-Khani et al.ᵔ, 2019). Theᵔ collectedᵔ data can then get synthesisedᵔ into what isᵔ known about

accessᵔ to mentalᵔ healthᵔ servicesᵔ by young peopleᵔ so that informedᵔ decisionsᵔ andᵔ appropriateᵔ

planning can beᵔ madeᵔ relativeᵔ to commitment to enhancing public healthᵔ outcomes. Secondary

researchᵔ isᵔ significant forᵔ thisᵔ researchᵔ sinceᵔ it isᵔ lessᵔ intrusiveᵔ considering sensitiveᵔ topicsᵔ
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concerning individualᵔ healthᵔ (Cadiganᵔ, Leeᵔ andᵔ Larimerᵔ, 2019). Howeverᵔ, secondary researchᵔ isᵔ

also associatedᵔ withᵔ someᵔ shortcomingsᵔ, suchᵔ asᵔ accessᵔ to outdatedᵔ information resulting from

theᵔ timeᵔ it takesᵔ forᵔ researchᵔ articlesᵔ forᵔ publishedᵔ to get completed. However, Someᵔ of theᵔ

information gatheredᵔ from secondary researchᵔ can also beᵔ biasedᵔ, leading to badᵔ outcomes.

Thereforeᵔ, conducting researchᵔ basedᵔ on a literatureᵔ review requiresᵔ a person to beᵔ critical. Theᵔ

collectedᵔ data must beᵔ reliableᵔ andᵔ validᵔ, whichᵔ meansᵔ that data shouldᵔ get obtainedᵔ from many

sourcesᵔ andᵔ severalᵔ independent researchers.

Theᵔ criticalᵔ Appraisalsᵔ Skillsᵔ Programmeᵔ (CASP) isᵔ a valuableᵔ toolᵔ forᵔ conducting

research. Theᵔ CASP checklistsᵔ coverᵔ threeᵔ key areas: resultsᵔ, validityᵔ, andᵔ clinicalᵔ relevanceᵔ, andᵔ

it isᵔ also helpfulᵔ forᵔ determining theᵔ quality of evidenceᵔ (CASPᵔ, 2018). CASP includesᵔ an index

that fitsᵔ most studiesᵔ andᵔ isᵔ suitableᵔ forᵔ an in-depthᵔ selection of articles. Thereᵔ areᵔ variousᵔ

qualitativeᵔ studiesᵔ to accessᵔ when identifying barriersᵔ to accessᵔ to mentalᵔ healthᵔ services.

Thereforeᵔ, it isᵔ essentialᵔ to useᵔ theᵔ CASP checklistsᵔ forᵔ qualitativeᵔ research. Theᵔ CASP checklist

forᵔ qualitativeᵔ studiesᵔ containsᵔ ten questionsᵔ, andᵔ theᵔ first two areᵔ screening questionsᵔ to seeᵔ if

theᵔ study yourᵔ findᵔ isᵔ appropriateᵔ (CASPᵔ, 2018). I willᵔ useᵔ CASP on allᵔ theᵔ articlesᵔ selectedᵔ to

achieveᵔ clarity andᵔ transparency whileᵔ doing my dissertation.

5.1 Literatureᵔ Searchᵔ Strategy

I willᵔ conduct a literatureᵔ searchᵔ by identifying andᵔ isolating theᵔ keywordsᵔ of theᵔ researchᵔ

question to get accurateᵔ results. A successfulᵔ literatureᵔ searchᵔ withᵔ keywordsᵔ from theᵔ researchᵔ

question andᵔ key componentsᵔ usedᵔ in PICO enablesᵔ researchersᵔ to obtain sufficient information

about theᵔ topic (Talevi et al.ᵔ, 2020). Theᵔ keywordsᵔ forᵔ my researchᵔ question areᵔ young peopleᵔ,

barriersᵔ to accessᵔ mentalᵔ healthᵔ servicesᵔ, facilitatorsᵔ of mentalᵔ healthᵔ servicesᵔ, Unitedᵔ Kingdomᵔ,

identify obstaclesᵔ andᵔ improveᵔ accessᵔ to mentalᵔ healthᵔ services. Then I willᵔ useᵔ theᵔ mentionedᵔ
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keywordsᵔ andᵔ searchᵔ withᵔ synonyms. Most up-to-dateᵔ literatureᵔ willᵔ get foundᵔ in articles. I willᵔ

accessᵔ theᵔ searchᵔ engineᵔ Googleᵔ Scholarᵔ to exploreᵔ theᵔ literature. Googleᵔ Scholarᵔ isᵔ simpleᵔ to

accessᵔ andᵔ providesᵔ an easy way to searchᵔ forᵔ literatureᵔ, bothᵔ articlesᵔ andᵔ booksᵔ broadly. Alsoᵔ,

grey literatureᵔ from think tanksᵔ willᵔ get considered.

Databasesᵔ suchᵔ asᵔ PubMedᵔ, CINAHLᵔ, PsycINFOᵔ, andᵔ EBSCO willᵔ get accessedᵔ to

conduct research. PubMedᵔ isᵔ a massiveᵔ databaseᵔ andᵔ containsᵔ, among othersᵔ, literatureᵔ from lifeᵔ

scienceᵔ journalsᵔ, whereasᵔ CINAHL includesᵔ top journalsᵔ andᵔ theᵔ most current nursing andᵔ alliedᵔ

healthᵔ literatureᵔ (CINAHLᵔ, 2020). PsycINFO isᵔ theᵔ largest resourceᵔ forᵔ peer-reviewedᵔ literatureᵔ

in mentalᵔ healthᵔ andᵔ behaviouralᵔ science. Information on psychologicalᵔ aspectsᵔ of relatedᵔ fieldsᵔ

suchᵔ asᵔ psychiatricᵔ, sociologyᵔ, educationᵔ, anthropologyᵔ, andᵔ othersᵔ get containedᵔ in theᵔ databaseᵔ

(PsycINFOᵔ, 22). It isᵔ recommendableᵔ to searchᵔ at least two databasesᵔ to provideᵔ in-depthᵔ

information about theᵔ chosen topic. Mentionedᵔ databasesᵔ areᵔ allᵔ relevant to theᵔ researchᵔ topic of

accessᵔ to mentalᵔ healthᵔ services. To refineᵔ theᵔ searchᵔ, Boolean operatorsᵔ areᵔ helpfulᵔ, whichᵔ areᵔ

wordsᵔ suchᵔ asᵔ ANDᵔ, ORᵔ, andᵔ NOT. Boolean operatorsᵔ areᵔ usedᵔ to combining keywordsᵔ to

narrow orᵔ broaden theᵔ literatureᵔ search. Theᵔ first instanceᵔ isᵔ to searchᵔ forᵔ primary literatureᵔ that

providesᵔ first-handᵔ researchᵔ findings. Applying inclusion andᵔ exclusion criteria willᵔ accessᵔ theᵔ

most relevant papers. Theᵔ timeᵔ frameᵔ isᵔ within theᵔ last fiveᵔ yearsᵔ to get theᵔ most up-to-dateᵔ

articles. Theᵔ searchᵔ willᵔ get restrictedᵔ to articlesᵔ written in Englishᵔ to keep theᵔ assignment within

theᵔ timeᵔ frame. Only peer-reviewedᵔ articlesᵔ willᵔ get includedᵔ in theᵔ searchᵔ termsᵔ to retain a highᵔ

articleᵔ quality andᵔ ensureᵔ sufficient scientific rigour. It isᵔ essentialᵔ to defineᵔ a searchᵔ strategyᵔ,

whichᵔ willᵔ makeᵔ it quickly to identify literatureᵔ relatedᵔ to theᵔ topic. Exclusion criteria willᵔ beᵔ

young peopleᵔ, mainly becauseᵔ theᵔ articlesᵔ showing up areᵔ from theᵔ states. Theᵔ researchᵔ question
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isᵔ about young peopleᵔ from theᵔ UKᵔ, andᵔ thereforeᵔ, it isᵔ to typeᵔ theseᵔ in theᵔ searchᵔ enginesᵔ orᵔ

databasesᵔ to excludeᵔ papersᵔ from otherᵔ countries.

5.1.1 Keywords

Keywordsᵔ areᵔ essentialᵔ to conducting theᵔ most relevant paperᵔ doing research. Every

study includesᵔ uniqueᵔ keywordsᵔ that can get comparedᵔ during a literatureᵔ search. Theᵔ study'sᵔ

keywordsᵔ are; young peopleᵔ, depressionᵔ, barriersᵔ, mentalᵔ healthᵔ, help-seekingᵔ, Unitedᵔ Kingdomᵔ,

help-seeking habitsᵔ, barriersᵔ to accessᵔ mentalᵔ healthᵔ servicesᵔ, andᵔ facilitatorsᵔ to accessᵔ mentalᵔ

healthᵔ services. Someᵔ databasesᵔ allow theᵔ useᵔ of symbolsᵔ asᵔ a wildcardᵔ orᵔ truncation. In thisᵔ

caseᵔ, truncation couldᵔ get appliedᵔ to young people'sᵔ mentalᵔ health. Forᵔ instanceᵔ, young people'sᵔ

mentalᵔ healthᵔ (?) andᵔ theᵔ databaseᵔ wouldᵔ findᵔ articlesᵔ about young people'sᵔ mentalᵔ health. Theᵔ

wildcardᵔ willᵔ findᵔ alternativeᵔ spellingsᵔ andᵔ get usedᵔ in databasesᵔ whereᵔ possible. Boolean

operatorsᵔ areᵔ usedᵔ to broadening orᵔ narrowing down theᵔ search. Someᵔ of theᵔ Boolean operatorsᵔ

usedᵔ in theᵔ study includeᵔ ANDᵔ, ORᵔ, andᵔ NOT. Theᵔ following examplesᵔ represent what theᵔ

searchᵔ willᵔ look like:

 Young peopleᵔ, mentalᵔ healthᵔ servicesᵔ orᵔ depression AND theᵔ UKᵔ, theᵔ Unitedᵔ

Kingdomᵔ, Britainᵔ, orᵔ Englandᵔ, NOT olderᵔ people.

 Help-seeking orᵔ treatment-seeking orᵔ treatment engagement orᵔ serviceᵔ

utilisation orᵔ utiliseᵔ mentalᵔ healthᵔ servicesᵔ AND stigma orᵔ attitudeᵔ orᵔ

discrimination AND mentalᵔ healthᵔ orᵔ bereavedᵔ by depression AND young

peopleᵔ orᵔ UK young people.

 Young peopleᵔ AND mentalᵔ healthᵔ servicesᵔ orᵔ seeking mentalᵔ healthᵔ services
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Theᵔ focusᵔ of theᵔ searchᵔ willᵔ beᵔ on young peopleᵔ in theᵔ Unitedᵔ Kingdom countriesᵔ to

broaden accessᵔ to information. Only accessing data from Englandᵔ wouldᵔ narrow down theᵔ searchᵔ

results. Althoughᵔ Walesᵔ, Englandᵔ, Northern Irelandᵔ, andᵔ Scotlandᵔ differᵔ on multipleᵔ healthcareᵔ

parametersᵔ, mentalᵔ healthᵔ information isᵔ comparableᵔ asᵔ relatedᵔ policiesᵔ get implementedᵔ acrossᵔ

theᵔ Unitedᵔ Kingdom.

5.1.2 Inclusion andᵔ exclusion criteria

Theᵔ studiesᵔ focusing on otherᵔ countriesᵔ apart from Englandᵔ get excludedᵔ from thisᵔ studyᵔ,

whichᵔ ensuredᵔ that studiesᵔ focusedᵔ on wereᵔ relevant to theᵔ topic underᵔ investigation. Moreoverᵔ,

thisᵔ researchᵔ excludedᵔ studiesᵔ publishedᵔ moreᵔ than ten yearsᵔ ago to ensureᵔ that thisᵔ study getsᵔ

basedᵔ on up-to-dateᵔ information. Alsoᵔ, thisᵔ researchᵔ excludedᵔ allᵔ non-Englishᵔ publishedᵔ articlesᵔ

sinceᵔ theᵔ study get basedᵔ in Englandᵔ, an English-speaking nation. Furthermoreᵔ, theᵔ researcherᵔ

includedᵔ studiesᵔ whoseᵔ participantsᵔ wereᵔ membersᵔ of theᵔ generalᵔ community groupsᵔ withᵔ

unrestrictedᵔ accessᵔ to a wideᵔ rangeᵔ of help-seeking opportunities.

Moreoverᵔ, thisᵔ researchᵔ excludedᵔ studiesᵔ focusing on mentalᵔ healthᵔ conditionsᵔ otherᵔ than

anxietyᵔ, depression orᵔ mentalᵔ distress. Finallyᵔ, thisᵔ study excludedᵔ studiesᵔ focusing on help-

seeking practicesᵔ pursuedᵔ on behalf of theᵔ affectedᵔ individualsᵔ, suchᵔ asᵔ thoseᵔ focusedᵔ on carersᵔ

orᵔ parentsᵔ seeking mentalᵔ healthcareᵔ servicesᵔ on behalf of theirᵔ consumersᵔ orᵔ children. Basedᵔ on

theseᵔ inclusion criteriaᵔ, 35 publicationsᵔ met theᵔ requirementsᵔ andᵔ got includedᵔ asᵔ relevant studiesᵔ

in conducting thisᵔ research.

7. ETHICAL CONSIDERATIONS

Ethicsᵔ in researchᵔ isᵔ essentialᵔ asᵔ it contributesᵔ to theᵔ successᵔ of any study. When

conducting theᵔ preliminary researchᵔ, a researcherᵔ directly interactsᵔ withᵔ theᵔ study subjectsᵔ, andᵔ

theᵔ researcherᵔ got expectsᵔ carefully considerᵔ allᵔ theᵔ ethicalᵔ requirements. Forᵔ instanceᵔ, theᵔ
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researcherᵔ shouldᵔ considerᵔ moralᵔ issuesᵔ suchᵔ asᵔ confidentialityᵔ, privacyᵔ, andᵔ disclosureᵔ when

conducting a study basedᵔ on primary data sources. Sinceᵔ theᵔ focusᵔ of thisᵔ study wasᵔ on

secondary data sourcesᵔ, theᵔ researcherᵔ didᵔ not haveᵔ to obtain subject consent asᵔ no human

subjectsᵔ got involvedᵔ in theᵔ study. Howeverᵔ, it wasᵔ important forᵔ theᵔ researcherᵔ to ensureᵔ that

whateverᵔ data sourcesᵔ consideredᵔ in thisᵔ study wereᵔ initially obtainedᵔ using theᵔ ethicalᵔ principlesᵔ

of conducting primary research.

Consequentlyᵔ, theᵔ studiesᵔ withᵔ vagueᵔ orᵔ unclearᵔ ethicalᵔ considerationsᵔ wereᵔ not

consideredᵔ appropriateᵔ secondary data sources. Thereforeᵔ, most of theᵔ articlesᵔ consideredᵔ in thisᵔ

study wereᵔ qualitativeᵔ andᵔ includedᵔ publishedᵔ journalsᵔ andᵔ reportsᵔ from governmentalᵔ andᵔ

privateᵔ agenciesᵔ focusing on mentalᵔ healthᵔ servicesᵔ accessibility issuesᵔ affecting young peopleᵔ

withᵔ depression in England. Howeverᵔ, someᵔ agenciesᵔ, suchᵔ asᵔ privateᵔ andᵔ public hospitalsᵔ, must

seek permission to accessᵔ data on theirᵔ websites. Forᵔ that reasonᵔ, theᵔ researcherᵔ emailedᵔ suchᵔ

organisationsᵔ to seek authorisation andᵔ assuredᵔ them that theᵔ data sought wasᵔ to beᵔ usedᵔ only forᵔ

academic purposes.

Following theᵔ researchᵔ andᵔ methodologiesᵔ usedᵔ in theᵔ analysisᵔ, theᵔ study discoveredᵔ

numerousᵔ barriersᵔ andᵔ challengesᵔ influencing young peopleᵔ withᵔ mentalᵔ healthᵔ challengesᵔ to

withdraw orᵔ chooseᵔ not to pursueᵔ treatment (Town et al.ᵔ, 2021). Theᵔ first finding gatheredᵔ from

theᵔ literatureᵔ review isᵔ young peopleᵔ in theᵔ UK. Forᵔ instanceᵔ, theᵔ study by Radez et al. (2021)

highlightedᵔ that conceptsᵔ likeᵔ socialᵔ factorsᵔ, relationship factorsᵔ, structuralᵔ andᵔ systemic

conceptsᵔ, andᵔ individualᵔ preferencesᵔ actedᵔ asᵔ barriersᵔ forᵔ young peopleᵔ encountering mentalᵔ

healthᵔ in bothᵔ theᵔ UK. Forᵔ instanceᵔ, socialᵔ factorsᵔ likeᵔ anticipatedᵔ orᵔ experiencedᵔ barriersᵔ

contributedᵔ to highᵔ ratesᵔ of fearᵔ of theᵔ stigma that demoralisedᵔ massiveᵔ numbersᵔ to do away withᵔ

diagnosisᵔ (Kelly et al. 2018). Even thoughᵔ family viewsᵔ andᵔ perceptionsᵔ of mentalᵔ healthᵔ
 13

challengesᵔ asᵔ weak also perseveredᵔ among theᵔ studies. Radez et al. (2021) highlightedᵔ that a lack

of support networksᵔ andᵔ discouragement from friendsᵔ andᵔ family fellᵔ heavierᵔ among young

peopleᵔ withᵔ mentalᵔ healthᵔ challengesᵔ in theᵔ UK. Howeverᵔ, bothᵔ parties' common fearsᵔ includedᵔ

losing group positionsᵔ, upsetting friendsᵔ orᵔ familyᵔ, andᵔ theᵔ fearᵔ of lossᵔ of academic growthᵔ orᵔ

employment.

On theᵔ otherᵔ handᵔ, furtherᵔ researchᵔ andᵔ literatureᵔ noteᵔ that theᵔ study'sᵔ focusᵔ groupsᵔ go

throughᵔ diverseᵔ barriersᵔ andᵔ facilitatorsᵔ contributing to a lack of treatment of mentalᵔ healthᵔ

conditions. Forᵔ instanceᵔ, Sadlerᵔ et al. (2018) noteᵔ that at least 12% of young peopleᵔ between theᵔ

agesᵔ of fiveᵔ andᵔ nineteen experienceᵔ mentalᵔ healthᵔ challengesᵔ without disclosing them to thoseᵔ

closeᵔ to them. Moreoverᵔ, young women in theᵔ UK representsᵔ oneᵔ of theᵔ high-risk group

susceptibleᵔ to experiencing mentalᵔ healthᵔ challengesᵔ without notifying any otherᵔ partiesᵔ

(MacDonaldᵔ et al.ᵔ, 2018). Howeverᵔ, an analysisᵔ of theᵔ significant factorsᵔ influencing barriersᵔ to

accessing mentalᵔ healthᵔ servicesᵔ forᵔ theᵔ UK groupᵔ, according to Aguirreᵔ et al. (2020)ᵔ, mainly

resonatedᵔ on theᵔ roleᵔ of cultureᵔ in defining self-identity andᵔ awareness. In additionᵔ, theᵔ authorsᵔ

noteᵔ that contrary to theᵔ western approachᵔ to mitigating problemsᵔ, most young peopleᵔ

experiencing mentalᵔ healthᵔ challengesᵔ look to theᵔ family forᵔ guidanceᵔ andᵔ counselling.

Nonethelessᵔ, most of thoseᵔ who participatedᵔ in theᵔ analysisᵔ notedᵔ that family andᵔ friendsᵔ

wereᵔ facilitatorsᵔ of barriersᵔ to gaining healthcareᵔ basedᵔ on stigma fears. Even thoughᵔ participantsᵔ

from theᵔ UK indicatedᵔ that stigma remainsᵔ deeply embeddedᵔ in theᵔ culturalᵔ setting (O'Reilly et

al. 2018). Forᵔ instanceᵔ, Aguirreᵔ et al. (2020) noteᵔ that perceptionsᵔ heldᵔ by young individualsᵔ

concerning seeking mentalᵔ healthᵔ focusedᵔ on demonstrating theᵔ weaknessᵔ in suchᵔ practices.

Consequentlyᵔ, most young peopleᵔ suffering from mentalᵔ healthᵔ challenge’sᵔ view family andᵔ

friendsᵔ asᵔ sourcesᵔ of stigma andᵔ negativeᵔ influenceᵔ (Jacob et al.ᵔ, 2020). Moreoverᵔ, theᵔ
 14

participantsᵔ in theᵔ analysisᵔ demonstratedᵔ that factorsᵔ likeᵔ self-awarenessᵔ influencedᵔ furtherᵔ

actionsᵔ regarding seeking mentalᵔ healthᵔ servicesᵔ (Sohn et al.ᵔ, 2019). Forᵔ instanceᵔ, a lack of

resourcesᵔ focusedᵔ on treating mentalᵔ healthᵔ among theᵔ UK'sᵔ young communitiesᵔ servedᵔ asᵔ a self-

imposedᵔ barrierᵔ to utilising availableᵔ resourcesᵔ (Pappi et al.ᵔ, 2021).

Following theᵔ distinct researchᵔ methodologiesᵔ usedᵔ in theᵔ analysisᵔ, evidenceᵔ pointsᵔ to a

literary gap concerning theᵔ barriersᵔ young peopleᵔ between 16 andᵔ 25 faceᵔ in mitigating mentalᵔ

healthᵔ challenges. Theᵔ Department of Healthᵔ (2014) notesᵔ thatᵔ, despiteᵔ theᵔ riseᵔ of mentalᵔ healthᵔ

among theᵔ youthᵔ, effectiveᵔ mentalᵔ healthᵔ practicesᵔ got neededᵔ to closeᵔ theᵔ literatureᵔ gap showing

increasedᵔ facilitatorsᵔ contributing to theᵔ concealment of suchᵔ proceduresᵔ by victims. Theᵔ sectorᵔ

insistsᵔ on engaging in recovery practicesᵔ following theᵔ massiveᵔ traumatic incidentsᵔ young peopleᵔ

withᵔ mentalᵔ disordersᵔ faceᵔ (Pedersen et al.ᵔ, 2019). Firstᵔ, closing theᵔ gap requiresᵔ a compelling

analysisᵔ of underlying influencersᵔ likeᵔ stigmaᵔ, fearᵔ of criticismᵔ, andᵔ culturalᵔ influence. Sinceᵔ theᵔ

study elaboratesᵔ on theᵔ conceptsᵔ, theᵔ Department of Healthᵔ (2018) insistsᵔ on including new first-

handᵔ information from affectedᵔ victimsᵔ to tackleᵔ mattersᵔ likeᵔ accessᵔ inequality andᵔ theᵔ lack of

utilisation of availableᵔ resourcesᵔ andᵔ services.

Theᵔ study'sᵔ findingsᵔ also integratedᵔ mentalᵔ andᵔ physicalᵔ healthᵔ careᵔ forᵔ advancedᵔ careᵔ

andᵔ consideration. Theᵔ Department of Healthᵔ (2018) notesᵔ that combining suchᵔ treatment

practicesᵔ can help young peopleᵔ withᵔ geographicalᵔ barriersᵔ orᵔ thoseᵔ underᵔ theᵔ heavy influenceᵔ of

family andᵔ cultureᵔ basedᵔ on considering self asᵔ theᵔ centralᵔ andᵔ criticalᵔ component forᵔ advancing

overallᵔ healthcareᵔ (Ueda et al. 2020). Moreoverᵔ, developing policiesᵔ likeᵔ no-turn-down practicesᵔ

forᵔ partiesᵔ suffering from mentalᵔ healthᵔ, especially from a young ageᵔ, can help manageᵔ theᵔ

perceptionsᵔ of stigma andᵔ a lack of adequateᵔ quality careᵔ servicesᵔ (Donnelly et al. 2018). Theᵔ

Department of Healthᵔ (2018) also notesᵔ that theᵔ family unit andᵔ cultureᵔ areᵔ integralᵔ in ensuring
 15

that young children suffering from mentalᵔ challengesᵔ get theᵔ necessary support andᵔ remain

includedᵔ in decision-making practicesᵔ forᵔ advancedᵔ care. Howeverᵔ, Chaseᵔ, Rezaieᵔ, andᵔ Zada

(2019) noteᵔ that sinceᵔ theᵔ cultureᵔ in theᵔ UK contradictsᵔ in diverseᵔ settingsᵔ, applying patients'

context isᵔ essentialᵔ in advancing reasonableᵔ healthᵔ practicesᵔ andᵔ functionsᵔ forᵔ assisting young

peopleᵔ withᵔ mentalᵔ healthᵔ issuesᵔ to accessᵔ adequateᵔ andᵔ suitableᵔ services.

Following theᵔ study'sᵔ findingsᵔ, an effectiveᵔ recommendation suitableᵔ forᵔ advancing

accessᵔ andᵔ delivery of mentalᵔ healthᵔ servicesᵔ to young peopleᵔ in theᵔ UK isᵔ theᵔ integration of

early treatment practicesᵔ (Leeᵔ, 2020). Theᵔ Department of Healthᵔ (2014) notesᵔ that partiesᵔ who

begin to promoteᵔ children'sᵔ wellbeing at early agesᵔ throughᵔ collaboration withᵔ healthcareᵔ

professionalsᵔ andᵔ theᵔ family ensureᵔ that theirᵔ children remain moreᵔ equippedᵔ to dealᵔ withᵔ

challengesᵔ likeᵔ stigmatisationᵔ, fearᵔ of traumaᵔ, andᵔ withdrawalᵔ from engaging in life. Alsoᵔ, theᵔ

Department of Healthᵔ (2018) highlightsᵔ theᵔ needᵔ forᵔ offering support recovery interventionsᵔ

beginning in theᵔ young people'sᵔ householdᵔ to advanceᵔ parentalᵔ andᵔ culturalᵔ support in seeking

effectiveᵔ treatment practices. Forᵔ instanceᵔ, providing education to parentsᵔ andᵔ guardiansᵔ of

children withᵔ mentalᵔ disordersᵔ can assist in offering mentalᵔ andᵔ psychologicalᵔ support neededᵔ to

advanceᵔ practicalᵔ living without theᵔ feelingsᵔ of discriminationᵔ, contemptᵔ, orᵔ segregation

(Daneseet al.ᵔ, 2020). Furthermoreᵔ, by insisting that mentalᵔ healthᵔ involvesᵔ every person in

different contextsᵔ, theᵔ Department of Healthᵔ (2018) recommendsᵔ engaging in public awarenessᵔ

campaignsᵔ that can assist in driving out theᵔ underlying stigma surrounding mentalᵔ healthᵔ

treatmentᵔ, accessᵔ, andᵔ care.

Theᵔ analysisᵔ servesᵔ asᵔ a stepping stoneᵔ to futureᵔ researchᵔ andᵔ analysisᵔ concerning furtherᵔ

elaborating on underlying challengesᵔ, barriersᵔ, andᵔ facilitatorsᵔ of limitedᵔ accessᵔ to healthᵔ

interventionsᵔ forᵔ children withᵔ mentalᵔ healthᵔ (Deighton et al.ᵔ, 2019). Theᵔ foundation brought by
 16

theᵔ study isᵔ essentialᵔ forᵔ promoting theᵔ engagement of partiesᵔ likeᵔ healthcareᵔ professionalsᵔ,

parentsᵔ, andᵔ culturesᵔ in promoting mentalᵔ healthᵔ awarenessᵔ, serviceᵔ, andᵔ delivery.

7. TIMEFRAME TABLE

Proposalᵔ Acceptance 12thᵔ – 17thᵔ Aprilᵔ 2022

Supervisor’sᵔ Feedback 17thᵔ – 22ndᵔ Aprilᵔ 2022

Proposalᵔ modifications 22ndᵔ -24thᵔ Aprilᵔ 2022

Searching andᵔ gathering resources 24th- 27thᵔ Aprilᵔ 2022

Evaluating literature 27th- 30thᵔ Aprilᵔ 2022

Examining Ethics 1st – 4thᵔ May 2022

Writing Objectives 5th-8thᵔ May 2022

Analysing Data 8thᵔ – 12thᵔ May 2022

Supervisor’sᵔ Feedback 12th- 16thᵔ May 2022

Writing Methodology 16th-18thᵔ May 2022

Supervisor’sᵔ Feedback 18th-22ndᵔ May 2022

Writing Resultsᵔ andᵔ Discussion 22nd-25thᵔ May 2022

Supervisor’sᵔ Feedback 25th- 28thᵔ May 2022

Writing reflectiveᵔ Account 28th-31st May 2022

Proofreading 31st-5thᵔ Juneᵔ 2022

 17

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