There are many reasons that young people may choose not to make use of mental health services. One reason may be that the term ‘mental health’ itself has connotations that fail to represent the benefits of the service or even deter potential clients from those services.
The stigma attached to the label ‘mental’ is well established. In recent history, the word mental has been used in negative contexts and more recently it has been used as a positive term within youth culture to communicate what is cool or exciting. In 2006, Australian researchers from several universities, Wisdom, Clarke and Green1 suggested that for young people the term mental health sends a message that the problem lays in their mind and elicits a fear of being labelled or judged as ‘mental’ by friends and family.
In the 1992 Australian report for the National Youth Affairs Research Scheme young people reported confusion about the term mental health, responding that mental health was a disability, indicated you are mentally incapable, handicapped and had problems with thinking. This confusion may affect their willingness to access services or to understand what service is being suggested or offered2.
In recent interviews with mental health service providers, one person suggested to us that we should be drawing on a term that more accurately reflects the focus of interventions in healing the effects of trauma, abuse, grief and loss for children and young people under guardianship. The words used should also reflect that the feelings or concerns that brought them to the services is the result of an experience and not their fault.
Services and workers therefore need to use terms that are understood by young people and explain the terms used3. Information, education and clarification also reduces stigma.
Research undertaken with young people suggests that whilst stigma and confusion can be a barrier, there are other barriers to overcome.4. Among these are long waiting lists, unsatisfactory past experiences with service providers, poor location of services, concerns about privacy and lack of informal supports to encourage them.5
The role of significant others is critical to overcoming these barriers and getting young people to seek the help they need. Educators, general practitioners, residential care workers or youth workers6, are often the first point of contact for young people in talking about emotional problems. Positive and supportive responses at this point can help to normalise the experience, challenge any stigma, correct misconceptions and support them to go to see someone.
Workers can also be directed by the young people themselves in how best to define the therapeutic relationship, the experience, and the mental health service. In other words, use terms that are understood by young people or take the time to explain other terms that cannot be avoided.
1 Wisdom, JP, Clarke GN & Green CA (2006), ‘What teens want: barriers to seeking care for depression’, Adm Policy Mental Health, Vol. 22, 133 – 145 cited in Rickwood, Deane & Wilson, 2007, ‘When and how do young people seek professional help for mental health problems?’ Medical Journal of Australia, Vol 187, no. 7.
2 Sawyer, Meldrum, Tonge & Clark (1992), ‘Mental health and young people: A report into the nature of mental health problems experienced by young people and implications for service provision: A report to the National Youth Affairs Research Scheme’, Australian Clearinghouse for Youth Studies, University of Tasmania.
4 Research cited in Rickwood, Deane & Wilson, 2007, ‘When and how do young people seek professional help for mental health problems?’, Medical Journal of Australia, Vol. 187, no.7
5 op. cit. Sawyer, Meldrum, Tonge & Clark (1992)