“We Are Humans, and We Are People” - A Thematic Analysis Exploring the Disclosure and Help-Seeking Experiences of Young People Who Experience Voice-Hearing Within Mental Health Services in the UK

Background Voice-hearing is increasingly being recognised as a transdiagnostic experience which is common for children and adolescents. However, little is known about how young people seek help and disclose voice-hearing within mental health services. Method This qualitative study explored the disclosure and help-seeking experiences of nine young people (aged 14–18) receiving care from mental health services in the UK. Semi-structured interviews were conducted and analysed using thematic analysis within a critical realist framework. Results Two superordinate themes were identified: barriers to accessing help; facilitators to accessing help; and the impact of practitioner response on young people’s engagement. Stigma, long waiting lists for services, and practitioners’ lack of knowledge often acted as barriers to disclosure and help-seeking, whereas trust and clear communication facilitated disclosure and engagement. Participants often wished to be listened to, to be offered a more personalised approach and greater flexibility from mental health services. When practitioners demonstrated empathy and allowed trust to build in the therapeutic relationship, participants felt valued. Conclusions Findings suggest that practitioners might need to be supported to build confidence in discussing voice-hearing with young people to facilitate therapeutic conversations about these experiences, and that offering flexible, person-centred support may support young people’s engagement with mental health services.