Understanding mental health and help-seeking among adolescents in Europe: a focus group-based participatory study to inform preventive interventions

Background This multi-centre, qualitative study aimed to identify dimensions of mental health and possible determining factors of help-seeking among young people in Europe. Based on adolescent experiences, key risk factors for their mental health should be detected to inform preventive interventions. Focus group sessions were conducted in Cyprus, Germany, Italy, Poland, Slovenia, Spain, and the UK with adolescents aged 10 to 24 years, and their stakeholders (parents, school professionals and clinicians). The discussions followed a broad rationale asking about stressors, coping strategies, and barriers and facilitators of help-seeking. The recorded sessions were transcribed and analysed via thematic analysis. All seven sites conducted the analysis in local languages and final results were collated after translation. Overall, 124 adolescents and 81 stakeholders participated in 40 focus groups. Across all age groups of adolescents, pressure to perform academically and social life were core influencers of mental health. Trust was the key prerequisite for seeking support, whereby personal contacts were the foremost points of contact. Both groups recognized advantages and limitations of digital resources, although adolescents were more likely to mention positive aspects. Adolescents and stakeholders both viewed lack of trust and fear of judgment as significant barriers against accessing support services. Risk factors for the mental health of adolescents encompassed both personal and sociocultural aspects. Our findings highlight the need for mental health literacy of adolescents and their stakehoders to overcome personal risk factors. Sociocultural prevention must focus on building secure, non-judgmental relationships within school environments and professional support systems.