Perceptions of Mental Health, Mental Health Needs and Access to Mental Healthcare Among Justice-Involved Young People: A Systematic Review of Qualitative Evidence.

Justice-involved young people face high rates of mental disorders, yet their needs often go unmet and their engagement with mental healthcare is low. Personal accounts by such young people are crucial for understanding how to enhance service delivery and informing future research. Bringing these together is important for narrowing the gaps in practice and research in this field. The aim of this study is to answer, from published literature, two key questions: (1) How do young people involved with justice systems perceive their mental health and what factors influence these perceptions? (2) What do they view as barriers and facilitators to access to mental healthcare when within the justice system and what are their care preferences? A systematic review and thematic synthesis were conducted using English-language studies that reported qualitative data on such views. Eight electronic databases were searched, as was the grey literature. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Twenty-four studies involving 887 participants under the age of 21 were included. Four overarching themes emerged, with 15 supporting streams. Highlighted themes were low mental health literacy, stigmatising perceptions towards mental health and lack of trust in other people or the system. A call for belonging and connection with others was identified. Justice-involved young people often fall through the cracks of the mental healthcare system due to systematic, environmental and individual challenges. Better awareness of the personal experiences and concerns of these young people is essential for service and system improvements.