Challenges to Treatment for Adolescents

Challenges to mental health treatment exist across the board throughout age groups, populations, socio-economic classes, and countries. Although some face greater challenges than others, mental health remains a difficult subject for many to broach and a difficult service for many to receive. For adolescents, this can be particularly true as adolescence, in and of itself, can be a confounding phase for the adolescent and the family alike. There are barriers to adolescents receiving the mental health treatment that they need, and the most frightening part of these challenges is that many mental health disorders begin to present in adolescence and young adulthood. Did you know that about 75 percent of adults with a mental health disorder experienced the onset before the age of 24? Did you also know that suicide is the third leading cause of death among those aged 10-24 years old? Due to these statistics, it is clear that this group cannot be ignored when it comes to assessment, diagnosis, and treatment of mental health disorders.

Some of the challenges for this vulnerable group involve lack of access to services; others are related to the stigma associated with receiving treatment for a mental health diagnosis. Regardless of reason, one thing that we do know is that solutions need to be found for this ever important and growing need. Challenges within the system that affect the ability of adolescents to obtain treatment include:

●       Lack of access

●       Financial concerns

●       Referrals

●       Confidentiality 

Need for trained professionals

Lack of access includes several components. Lack of access to a clinician can be problematic, in that there just are not enough professionals out there who are trained to treat mental health disorders. In many school districts, mental health professionals are shared between several schools and unavailable to focus on a set caseload or provide continuity of care to struggling teenagers. The idea that an adolescent would have to speak to several counselors or clinicians to receive treatment, or not be able to receive treatment on a steady schedule is an immense challenge.

Need for greater resources

Lack of access can also be due to finances, meaning that some insurance companies will not pay for, or will set a limit on the amount of inpatient and outpatient treatment that adolescents can have, leaving the client to pay for services privately, and for a group aged 10-24, this does not seem like a probable outcome. Furthermore, access to services can be restricted if the adolescent is homeless, without insurance, or does not have access to reliable transportation.

Need for greater privacy

 There is also the problem of lack of confidentiality, meaning that some states and some clinicians may not allow a minor to explicitly consent to their own outpatient medical treatment. This can create a challenge if this adolescent is not comfortable explaining to a parent or guardian about the symptoms that brought them to seek treatment. If an adolescent wants to seek treatment for depression or suicidal thoughts/ideations, this may not be something that the individual feels they can tell a parent or guardian.

Need for stream-lined approach for professionals

A lack of referrals is also at play and can be seen in a circumstance with a primary care physician. Most adolescents visit their primary care physician at least once a year as they typically need to keep up with physicals or shots for upcoming school years. These practitioners have an opportunity to use these yearly meetings with adolescents as a time to question their mental health, as well as their physical health. Practitioners who do not use screenings for mental health could be missing a viable opportunity to check for signs and symptoms of mental health disorders. Primary care physicians may already be struggling with an inundation of documentation to complete with patients and may not have a stream-lined way to document mental health concerns as they arise in their patient visits.

Stigma around mental health

Stigma is a word that we have begun to hear much about as the importance of mental health has taken over our morning TV programs, social media, and the news. The stigma surrounding mental health keeps people from seeking treatment for fear that they may be seen as weak or unable to solve their own problems. In our individualistic culture, the idea of solving one’s own problems is seen as equivalent to strength so therapy is not always considered a valuable resource. Stigma against seeking treatment keeps both adults and adolescents from being treated for mental health concerns. Adolescence is a time of developing close relationships with friends and romantic partners and these relationships may be thought to be enough support for the adolescent and their own form of “therapy.”

Overall, it is important to remember that challenges facing adolescents in terms of treatment come from both internal and external forces. It is the lack of appropriate resources, as well as the feelings of shame that may come along with the need for professional help.