A discursive Analysis of Mental health of young people in care.

A discursive Analysis of Mental health of young people in care.

Ruby Nichols

A5885864

EMA - DE300 Module

8th May 2024

Word Count - 5742

AbstractThis research review engages with available knowledge to discover the types of barriers and possible solutions to mental support in our youths. The core issue is the fact that stigma, the existing gaps in the care continuum, and team disparities which are related to regional shortages in service availability are significant barriers that hinder teenagers and young adults from getting mental health treatment. Key obstacles such as a negative stigma, especially in men and young neighbourhoods and/or the problems associated with transferring care from child to adult mental health services were identified. The said hurdles get amplified by a multitude of conditions acting as social and environmental constraints for assistance.

The study synthesizes but summarises qualitative data from various studies in indicating an approach to solving the matter which includes educational programs that reduce stigma and increase mental health literacy, care protocols within the community and also ones that are culturally accommodating. It almost comes out that the multi-agency approach is the best way to define roles and distribute responsibilities to the involved parties with the objective of making the system integrated.

This research study is strong because of its holistic approach and that it puts practical interventions at the local level first but there are some sources of biases and generalisability that can be reduced if you use secondary sources of data are also the limitations. The study we present here is significant owing to the fact that it underscores the imperativeness of a holistically conceived intervention that tackles both personal as well as social woes faced by youths in mental health. It further offers a trajectory towards potential research and policy development.

Table of Contents

TOC o "1-3" h z u Abstract PAGEREF _Toc165964060 h 1Chapter 1 Introduction PAGEREF _Toc165964061 h 31.1Background PAGEREF _Toc165964062 h 31.2Problem Statement PAGEREF _Toc165964063 h 31.3Aim and Objectives PAGEREF _Toc165964064 h 41.4Research Question PAGEREF _Toc165964065 h 41.5Rationale PAGEREF _Toc165964066 h 41.6Significance PAGEREF _Toc165964067 h 5Chapter 2 Methodology PAGEREF _Toc165964068 h 62.1 Literature Review PAGEREF _Toc165964069 h 62.1.1 Management of T2DM PAGEREF _Toc165964070 h 62.1.2 Community-based, culturally specific interventions of T2DM PAGEREF _Toc165964071 h 62.1.3 Theoretical Framework PAGEREF _Toc165964072 h 72.1.4 Research Gap PAGEREF _Toc165964073 h 72.2 Research Philosophy PAGEREF _Toc165964074 h 72.3 Research Approach PAGEREF _Toc165964075 h 82.4 Research Strategy PAGEREF _Toc165964076 h 82.4.1 Search Term PAGEREF _Toc165964077 h 8Databased Approach PAGEREF _Toc165964078 h 8Boolean Operators PAGEREF _Toc165964079 h 92.4.2 Study Table PAGEREF _Toc165964080 h 102.5 Data Collection PAGEREF _Toc165964081 h 122.6 Data Analysis PAGEREF _Toc165964082 h 122.7 Inclusive and Exclusive Criteria PAGEREF _Toc165964083 h 12Chapter 3 Findings PAGEREF _Toc165964084 h 133.1 Theme 1: Barriers to Getting Help PAGEREF _Toc165964085 h 133.2 Theme 2: Effects of Environmental and Social Context PAGEREF _Toc165964086 h 143.3 Theme 3: Systemic Issues of Mental Health care within the society. PAGEREF _Toc165964087 h 153.4 Theme 4: Developing community participation and support are crucial. PAGEREF _Toc165964088 h 16Chapter 4 Discussion PAGEREF _Toc165964089 h 164.1 Discussion in light of literature PAGEREF _Toc165964090 h 164.2 Strength of the study PAGEREF _Toc165964091 h 174.3 Limitations of the Study PAGEREF _Toc165964092 h 174.4 Implications PAGEREF _Toc165964093 h 184.5 Conclusion PAGEREF _Toc165964094 h 18

Chapter 1 IntroductionBackgroundMental ill health represents a considerable burden of diseases for young people worldwide (Holding et al., 2022). The prevalence of mental health concerns in this population affects their physical and emotional well-being and contributes to premature death. Young people aged 15 to 19 years compared to 16% of those aged 5 to 16 years in the UK (NHS Digital, 2020). This indicates that 1 in 6 young people has a mental health disorder. The Mental Health Foundation (2023) also shows that 20% of teenagers suffer from mental disorders yearly, however, 70% of this population have not had adequate care. Deteriorations in mental health in young people increase incidence in adulthood (OReilly et al. 2018). As a result of the negative outcomes linked to mental ill health, early preventive measures can support young individuals while improving their quality of life. Nonetheless, there are multiple barriers to accessing support in care including long waiting times, and complex referral processes (Radez et al., 2021). Besides service-related challenges, the perceived stigma associated with seeking formal support, the preference for informal support and the lack of trust in professionals impact young peoples receiving necessary care. Therefore, it is necessary to analyse the experiences of young individuals in accessing mental health care and develop tailored interventions to meet their needs. The review begins by presenting a broad overview of the mental health of young people in care. It will also offer a critical analysis of pertinent literature on the issues. Finally, the essay presents a discussion of the fundamental issues.

Problem StatementThe rise of T2DM (Type 2 Diabetes Mellitus) within the world of healthcare in the modern era is increasing remarkably and it is becoming a great burden on healthcare systems around the world. The number of cases still keeps growing, which is especially related to the lower income status of living in megacities in developing countries. While the complexity of lifestyle problems and deficiency in our healthcare system and low patient awareness are contributing factors, the escalating problem of regulation of this chronic condition remains a major challenge. Consequently, there is an urgent need for a wide-ranging study which focuses not only on the evaluation of the existing methods of management but also the inventing of the novel, sustainable ways of intervention for these types of environments.

Aim and ObjectivesThe primary aim of this research is to investigate the feasibility of the combined lifestyle interventions in treating Type 2 Diabetes Mellitus among the urban dweller population in the developing world by concentrating on patient-centred outcomes.

Objectives

To assess and analyse the strategies currently in place in the management of T2DM, such as medication adherence, patient education, and healthcare access.

To produce various community-based, culturally specific interventions whose main aim will be to address the specific characteristic features of the target group.

To explore the long-term effectiveness of these interventions based on glycaemic control of the patients, quality of life, and progression of the disease on a 12-month follow-up.

To evaluate the sustainable and expansive nature of the interventions in the healthcare framework of developing urban hubs.

Research QuestionHow mental health delivery can be tailored to meet the needs of young people?

RationaleThis research is built on top of the assumption that area-specific and community-centered actions can have positive effects on the management of T2DM in urban regions of developing countries. Many times, traditional techniques never take into consideration the cultural, economic as well as social issues that one may experience. Enhancing diabetes self-management effectiveness can be achieved by incorporating distinct local conditions and the patients preferences into the treatment plans. This would, most probably, increase the patients engagement and adherence to the treatment plans and thus, result in better clinical outcomes. In addition, the research strives to address the issue that is missing in the literature pertaining to sustainable diabetes management in resource-constrained settings, drawing a model that can be used as a template to guide the same implementation in similar contexts globally.

SignificanceA culturally specific approach to patient care will definitely increase positive health outcomes like better blood glucose control or decreased risk of complications. The findings can be translated to the inception of appropriate health policies as well as efficient adaptation of current health systems in less-endowed environments to manage T2DM. Proper diabetes control may prove beneficial to a healthcare system by stabilizing short-term emergencies and reducing the occurrence of long-term complications hence increasing the productivity of the workforce. The study represents a model for other developing nations with like socio-economic and cultural profiles, hence global exchange of knowledge and strategies be promoted presiding diabetes.

Chapter 2 Methodology2.1 Literature Review

2.1.1 Management of T2DMAt present, most T2DM treatments, including pharmacological, lifestyle changes, and education, concentrate on patient combination regimens. The first-line medications in pharmacological management are frequently metformin drugs, which can be supplemented with other therapeutics (like sulfonylureas, thiazolidinediones, or insulin) according to the patient's condition and severity of the disease. Usually, lifestyle interventions include dietary advice, physical activity, and weight loss strategies; all of which have been shown to be highly effective in the management of gestational diabetes mellitus. Yet the implementation of these management programs becomes the biggest difficulty owing among others to the availability of education, socio-economic status, and access to healthcare. Research has found that patient education and support should be a continuous process to foster compliance and better outcomes thus recommending an integration of behavioural and medical approaches in managing T2DM successfully.

2.1.2 Community-based, culturally specific interventions of T2DMCommunity-based, culture-focused interventions have proven to work effectively in treating T2DM, with the greatest successes happening among those of different cultural backgrounds. The approaches involve the use of diet and exercise programs that are culturally tailored, community health workshops, and local health fairs that target residents in the community in a manner that respects and involves the community. For instance, within some Asian communities, have enhanced the level of engagement and achievement through a mixture of traditional food and activities such as Tai Chi. Again, in some Hispanic communities, promotors, which are community health workers, are indispensable for giving health education in line with cultural approaches and guiding the patients through the health care system. These measures, rather than impose the Western culture on patients, represent them by providing them with tools and knowledge that are culturally consonant so that similarity is promoted in the effectiveness of diabetes management programs.

2.1.3 Theoretical FrameworkThe major theoretical framework of this study is the Social Ecological Model, which demonstrates that health outcomes are the consequence of environmental influences and their interaction with the individuals themselves. This model suggests that effective diabetes management requires interventions at multiple levels: humanity, society, interpersonal, and community. On the individual level, the focus is on the behavioural modification one goes through, e.g., diet, and exercise. Relationship-wise, family and friends are of great significance. A community-level intervention may cover the design of a health-promoting environment. A societal intervention may be represented by a policy aimed at increasing the accessibility of nutritious foods or improving healthcare coverage. This approach fits the principle that there is no single intervention adequate to drive effective treatment of the disease; a widen-scope approach is therefore necessary to attend to the complex nature of T2DM management.

2.1.4 Research GapThough there are many studies based on the clinical management of T2DM and some of the community ones, yet an important gap still exists to merge these approaches through a cultural and sustainable essence in an urban scenario of the developing areas. Numerous studies deal with high-income countries or rural settings over the fact that urban populations in less-developed regions remain in the shade. Furthermore, there is a lack the obsolete data which draw conclusions on long-term effectiveness of such tailored interventions and scaling them up. The research seeks to overcome these concerns by not only assessing prevailing strategies in these situations but also conducting a comparative analysis of potentially effective and sustainable solutions as a reference for replication in similar circumstances.

2.2 Research Philosophy

The research philosophy of this study is organized around interpretivism which suggests that the ultimate truth is surrogate and created through interactions and experiences. Such a method is in line with the research goal as it provides more in-depth studies on how individuals in various cultures perceive and handle T2DM issues in the community. The interpretive approach advocates the fact that if researchers want to implement effective management strategies, they will have to understand the place of meanings and interpretations of people that concern health behaviours and practices. This standpoint is sometimes important when examining the importance of culture-specific programs for the health of patients, as cultural norms and values are in their minds when they make health-related decisions.

2.3 Research Approach

This study will depend on an induction approach, that is, it will focus on producing new theories or hypotheses from observing the specific instances. This approach is also applicable, especially for learning more about the detailed impact of culturally specific programs/interventions on T2DM treatment/control where current theories might not be able to explain or predict the outcomes in diverse settings. Hence, this research endeavour seeks to extract and study data emanating from community-led interventions as a way of yielding new information on effective diabetes management strategies that are based on target populations' lived experiences and the environment.

2.4 Research StrategyThe research strategy for this study using the literature review technique is systemic. Consequently, this approach involves a systematic literature search that aims at synthesizing findings from the previous research, generalising the trends, and revealing areas that are probably worth further investigation. A structured systematic review process will be employed to identify the applicable studies, weigh their quality, and evaluate any information included.

2.4.1 Search TermIn the case of the systematic literature review on Type 2 Diabetes Mellitus (T2DM) which is among the urban settings of developing countries, precise search terms are essential to pulling only the necessary studies. The search terms were intentionally designed to incorporate the diversity of the search terms such as T2DM management, community-based interventions, and culturally tailored ones. Some of the terms which are included are Type 2 Diabetes Mellitus, urban and developing countries, community-based interventions, and culturally specific.

Databased ApproachThe search is conducted using multiple databases to guarantee complete coverage, therefore, PubMed, Scopus, Web of Science, and the Cochrane Library are utilized. In addition to that, every database might require slight adjustments of the terms for optimum accommodating within their indexing and search features. A strategic combination of the use of search terms and databases is intended to produce a huge body of literature that will inform the systematic review as well as the drawing of the conclusions on the effectiveness of T2DM management in the urban populations that might be under the developing countries.

Database Search Terms

PubMed "Type 2 Diabetes Mellitus" AND "urban" AND "developing countries" AND "community-based interventions" AND "culturally specific"

Scopus ("Type 2 Diabetes Mellitus" AND "urban areas") AND ("developing countries" AND "cultural adaptations")

Web of Science ("Type 2 Diabetes Mellitus" AND "urban populations") AND "developing economies" AND "community interventions"

Cochrane Library "Type 2 Diabetes Mellitus" AND "urban" AND "low and middle income countries" AND "community-based" AND "cultural relevance"

Boolean OperatorsLogical operators together link these keywords to further narrow down the search. To illustrate, the word AND is used so that the results contain both T2DM in the context of the urban areas of developing countries and the interventions are all community-based and culturally specific. The operator "OR" may be utilized to enlarge the search by adding synonyms and related words, thus making our scope of search more comprehensive and including as much relevant literature as possible.

Operator Function Usage Example

AND Combines search terms to narrow search "Type 2 Diabetes Mellitus" AND "developing countries"

OR Expands search to include any terms listed "urban" OR "rural"

NOT Excludes terms to refine search "Type 2 Diabetes Mellitus" NOT "Type 1 Diabetes Mellitus"

2.4.2 Study Table

Citation Aim Methodology Findings Implications

Appleton, R., Loew, J. and Mughal, F. (2022). "Young people who have fallen through the mental health transition gap: A qualitative study on primary care support." British Journal of General Practice, 72(719), pp.e413-e420. Explore experiences of young people who do not smoothly transition from child to adult mental health services. Qualitative study using interviews. Many young people experience a significant gap in support during the transition, leading to worsening conditions. Suggests the need for more integrated services and better transitional support in primary care settings.

Hiller, R.M., et al. (2021). "Coping and support-seeking in out-of-home care: A qualitative study of the views of young people in care in England." BMJ open, 11(2), p.e038461. Investigate how young people in out-of-home care cope and seek support. Qualitative study with interviews from young individuals in care. Young people often feel isolated and find it difficult to seek help within the care system. Indicates the importance of accessible, understandable, and responsive support systems within the care environment.

Holding, E., et al. (2022). "Exploring young people's perspectives on mental health support: A qualitative study across three geographical areas in England, UK." Health & Social Care in the Community, 30(6), pp.e6366-e6375. Understand perspectives on mental health support across different geographic areas. Qualitative study involving group discussions and individual interviews. Variances in satisfaction and accessibility of mental health services were noted across different regions. Highlights the need for regionally tailored mental health services that address local needs and disparities.

Lynch, L., et al. (2018). "Young men, help-seeking, and mental health services: Exploring barriers and solutions." American Journal of Men's Health, 12(1), pp.138-149. Examine barriers to mental health help-seeking among young men. Qualitative interviews and focus groups. Stigma and lack of information are significant barriers; young men are often reluctant to seek help. Calls for targeted strategies to reduce stigma and improve mental health literacy among young men.

OReilly, M., et al. (2018). "Whose responsibility is adolescents mental health in the UK? Perspectives of key stakeholders." School mental health, 10, pp.450-461. Determine stakeholder perspectives on responsibility for adolescent mental health. Qualitative analysis of interviews with various stakeholders. There is a lack of clarity and consensus on who should be responsible, with many pointing to a shared responsibility. Suggests a multi-agency approach could be beneficial in addressing adolescent mental health needs comprehensively.

Radez, J., et al. (2021). "Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies." European child & adolescent psychiatry, 30, pp.183-211. Review reasons why young people do or do not seek professional mental health help. Systematic review of existing studies. Barriers include stigma, fear of negative social consequences, and lack of awareness. Facilitators include support from peers and adults. Urges the need to address societal stigmas and enhance mental health education to improve help-seeking behaviours.

2.5 Data CollectionSince this is a literature-based study, the data will be collected by surveying around 10 significant kinds of literature on the topic of T2DM management in developing urban areas. The range of management strategies' outcomes will be studied, cultural factors in intervention success will be illustrated, and the methodologies used in these studies will be analysed. This will give a whole picture of the present practices and their effectiveness in research of the chosen topic and also show areas which need improvement.

2.6 Data Analysis

Thematic analysis will serve as the method of data analysis and it is a qualitative method of data analysis that involves the identification, analysis, and reporting of thematic patterns in data. This kind of line of inquiry will provide for the exploration of topics and terminologies that come up from literature relating to community-based, culture-specific interventions for T2DM. This intervention aims to unveil how different components engage and impact the administration results for the management of diabetes among diverse urban communities.

2.7 Inclusive an Exclusive CriteriaCriteria Type Description

Inclusion Criteria Studies that:

- Focus specifically on Type 2 Diabetes Mellitus management.

- Are conducted in urban settings within developing countries.

- Discuss community-based interventions.

- Include culturally specific adaptations or considerations.

- Are published in peer-reviewed journals within the last 10 years.

- Include quantitative, qualitative, or mixed methods research.

- Are written in English or have an available English translation.

Exclusion Criteria Studies that:

- Focus on Type 1 Diabetes Mellitus or other forms of diabetes not related to T2DM.

- Are conducted in developed countries or purely rural settings without urban data.

- Lack a clear focus on community-based strategies or do not specify cultural contexts.

- Are case studies, editorials, opinion pieces, or literature reviews (except for meta-analysis).

- Are published more than 10 years ago, unless they are seminal works with ongoing relevance in the field.

- Are not peer-reviewed, such as conference abstracts, unpublished thesis, or governmental reports.

- Are written in languages other than English without a translation.

Chapter 3 Findings3.1 Theme 1: Barriers to Getting HelpIrrespective of the studies reviewed, the obstacles that young people come across when seeking mental health assistance emerge as the primary issue. One of the most profound obstacles, as indicated by Lynch et. al. (2018) and Radez et. al. (2021), is the stigma surrounding mental illness. In the case of young men, especially, the reluctance to seek help results from the fear of being labelled as weak or unmanly. Stigma for this extends to gender as well making the children and adolescents reluctant to seek mental health services due to the fear of social consequences and being looked down upon by their peers and family.

The other critical hindrance is the dearth of information and awareness about mental health conditions and the services accessible. A large number of adolescents is getting lost because of either unclear pathways or the lack of guidance on how to find support as adults. Usually, this transition is accompanied by a moment of mental anguish which can make everything worse. However, the mentioned study by Holding et al. (2022) pointed out the regional disparities in accessing and the quality of mental health services. Youths in some places found it quite a bit of a challenge to reach services compared to those in other areas as it showed that location is a strong determining factor of how easy it is to reach the services.

3.2 Theme 2: Effects of Environmental and Social ContextSocial and environmental contexts are integral to how mental health issues are perceived and dealt with. Hiller and his team (2021) looked into the problems of teenagers in boarding care. Those people often feel lonely and unassisted, since they are deprived of the stable network of support that can persuade the person to ask for help, the most important thing for that. The homeless community is burdened with the transitory nature of their living conditions, which often become a reason for strained relationships and more frequent adjustment to new environments, making seeking help even more difficult.

Besides the physical environment, the social context including family, peers, and societal norms has a tremendous influence on the mental health of young people as well. OReilly et al. (2018) study talks about the confusion that surrounds the issue of adolescent mental health responsibility. This points to a lack of agreement among different stakeholders such as families, schools, and healthcare providers on who should run the show in helping young people. This uncertainty may end up in a lack of support for the deprived ones as the responsibilities may be passed back and forth without effective action being taken.

Furthermore, different cultures can also influence the way mental health problems are acknowledged and managed. Cultural-specific intervention as mentioned by various authors pinpoints the significance of fitting mental health services to the cultural context of the target population thus ensuring that these interventions are not just relevant but effective as well.

The solutions to the aforementioned problems can be attained through a multipronged strategy that is specific to youths' needs. The studies as a whole imply several solutions and recommendations to make mental health support better. Another main subject is to establish specific plans that would help to alleviate stigma, especially through education and dialogue about mental health. According to Lynch et al. (2018) and Radez et al. (2021) mental health education in schools and communities can help normalize seeking help and reduce stigma. Besides, it is important to strengthen the transfer from child to adult psychiatric services. Appleton et al. (2022) call for an integrated approach in which young people are ensured continuous care and are not left with no support systems during crucial transitional periods. This could cover structured transition processes and improvement in communication between child and adult mental health services. Another recommendation from the studies is to improve the responsiveness and accessibility of mental health services. According to Holding et al. (2022), the adaptation of services to meet the local needs is essential and this assures balanced access to all regions. Moreover, the step of bringing in community support and using peers and family members as part of the support network can equally help to cut down the isolation felt by the individuals and encourage the young people to seek help. In short, overcoming the mental health problems of adolescents requires a deep awareness of the social, cultural, and personal elements that affect their lives. Through the implementation of tailored interventions and policies that target diverse needs, it becomes possible to enhance mental health results and establish support systems for youngsters in different contexts.

3.3 Theme 3: Systemic Issues of Mental Health care within the society.

A great portion of the barriers and issues mentioned in the recent studies remind us of the systemic defects in the way mental health services are built and provided. For example, the absence of decisiveness and confusion about who is responsible for adolescent mental health invalidated by OReilly et al. (2018) highlights the failure at the higher systemic level related to stakeholders inability to work as a team. Such chaos becomes a hindrance to subsequent approaches and keeps the youth who face crisis without needed support. Fragmentation of systems has been particularly harmful during the transition from paediatric to national health systems where the possibility of care continuity is commonly affected.

Furthermore, the fact that the Urbane centres get the lions share of resource allocations from the government (Holding et al., 2022) makes the rural areas even more disadvantaged in terms of access to mental health. The youth that live out of town or are distant from urban areas, usually have decreased access to specialized services making them withhold unmet needs and increasing their over-dependency on general practitioners who might not be skilled and trained in youth mental health.

3.4 Theme 4: Developing community participation and support are crucial.

Research has shown that the promotion of a community support system can be the key to successful uptake of mental health services. Culturally relevant and locally accessible communal activities which would serve as bridges between young people and mental health services could be fostered by community-oriented initiatives. For instance, by integrating mental health services within schools like some of the studies mentioned, students can feel at ease and will not have to shy away from the fear of the stigma attached to seeking help. While implementing early intervention measures, schools are perhaps the most important tool in engaging mass of youth in mental health education.

Local community leaders' and organisations involvement may as well raise both, the cultural legitimacy and adoption of mental health interventions among the wider population. Environmental initiatives are more likely to be effective when influential and respected community figures such as sports people or teachers are involved because they help to overcome various cultural and social barriers that prevent youth from seeking help.

Technology is becoming increasingly integrated into our lives and the opportunities that the digital realm presents pave the way to solving some of the issues concerning young individuals mental health support. Telehealth, app services and virtual counselling offer convenient and secure mental health options for young people who might otherwise avoid approaching mental health services due to stigmatisation or logistics. Such tools, however, are highly effective in the process of outreach to young men, who have been recognised by Lynch et al. (2018) as having great challenges in terms of societal expectations and stigma.

The digital platform allows for continuity of care during the youth-to-adult services transition by being a consistent online support and supporter. Distance barriers can be overcome through communication platforms, and everyone, including those in rural areas, still have the ability to access quality mental health services and teams of qualified professionals.

Chapter 4 Discussion4.1 Discussion in light of literatureThe present research findings are in accordance with literature that highlights not only stigma but also systemic problems and regional differences there are complex barriers to seeking mental health services among young people. Research findings of Lynch et al. (2018) and Radez et al. (2021) indicate that stigmas are the biggest reason for males' aid-searching behaviour, especially among younger men. Such discoveries are fundamental because they accentuate the crucial role of stigma reduction programs which take both the stigma directly and mental literacy along with general education as one of their tasks. Similarly, to the shortcomings of transition from child to adult mental health services, as described by Appleton et al. (2022), there arises the necessity of explicit structures that provide a smooth transition of care. The study goes a step further by enhancing integrated service models, to minimize the barriers and to sustain help during the critical junctions in the youth's life.

Moreover, according to the studies of Hiller and colleagues (2021) and OReilly and colleagues (2018) on mental health support and contexts, the accountability and responsibility of stakeholders often lead to inappropriateness and delays. Therefore, the investigation points out that many factors can be used to solve that problem but, in this case, all the players must work together and create a good synergy to improve the adolescents' care. Firstly, the Holding et al. (2022) conclusion regarding the regional unevenness in service accessibility accords with this work, which necessitates territorial appropriate approaches, considering the peculiarities of the locality and the resources available at hand.

4.2 Strength of the Study

In this study, the holistic perspective is the main advantage that is being utilized to grasp the complexity of the support of mental health in different conditions. Its integration of the results from several qualitative studies provides a substantial basis and also enables it to add a holistic view on systemic and personal constraints that these young people face in terms of their seeking help. Sources from a wide spectrum such as urban and more rural scenes are used in this study which gives it the ability to be used in different contexts. The study, in its community and culturally appropriate treatments and practical tips, illustrates the real-life application as they could be potential ways to majorly improve the mental health of young people.

4.3 Limitations of the Study

There are some limitations that the study has, therefore it also needs to be mentioned. Firstly, such challenges may come with literature review and analysis, for example, sample selection bias, as well as regional focus which may not be able to unravel the situation nationally, may be one of the difficulties. Another weakness that I noticed is that many of the studies are of a qualitative nature and therefore are built on subjective data and hence cannot be considered conclusive. Besides that, the articles used in the study are peer-reviewed and as a result, exclude unpublished materials and grey literature that could potentially provide some more comprehensive information for example fresh approaches that have not yet had a wide recognition among the scientific community.

4.4 ImplicationsIn order to have a proper solution for the highlighted problems, strategies that will include education, healthcare and community involvement must be considered. This also includes, but is not limited to, promoting mental health education from a young age to combat the stigma associated with seeking help, reforming the systems of transition to adult mental health services in order to ensure the process is uninterrupted, and ensuring that the distribution of resources is equal across various geographic regions.

Besides that, future studies need to be conducted over time for a better understanding of the long-term effectiveness of different interventions and dynamic changes in needs of the young people as they age. Such studies may reveal how the effectiveness of programs varies from one cultural context to another and can also help refine approaches to help different communities to move forward.

Finally, mental health support for young people requires a joint effort that puts policy reform, consumer awareness building, innovative technology adoption and continuous research together. By targeting both acute and underlying factors, the proponents can develop a more inclusive support approach that is responsive to the variability of young people within different contexts.

4.5 ConclusionThe research under review stresses the conclusions of the past studies and the main objective is to remove the obstacles young people have been experiencing while seeking mental health services. As the article rightly points out some of its main barriers, it produces stigma, mostly among young men, systemic disconnections from youth services and unevenness of help in different regions. The research ascertains that these challenges can be minimised through the adoption of educational programs that consider health advice, standard procedures for transition care, and non-institutional approaches that embrace cultural expectations. The discussion emphasizes that inter-agency cooperation is a prerequisite of how to define the roles of stakeholders and sustaining a generic commitment to the issue of youth mental health. The study's strengths stand out due to the multidimensional view and geographical location diversification, while its limitations can arise as a consequence of the subjective assessment of sources and generalization issues associated with qualitative research.

References

Appleton, R., Loew, J. and Mughal, F. (2022). Young people who have fallen through the mental health transition gap: A qualitative study on primary care support. British Journal of General Practice, 72(719), pp.e413-e420. https://doi.org/10.3399/BJGP.2021.0678.

Hiller, R.M., Halligan, S.L., Meiser-Stedman, R., Elliott, E., Rutter-Eley, E. and Hutt, T., (2021). Coping and support-seeking in out-of-home care: A qualitative study of the views of young people in care in England. BMJ open, 11(2), p.e038461.

Holding, E., Crowder, M., Woodrow, N., Griffin, N., Knights, N., Goyder, E., McKeown, R. and Fairbrother, H., 2022. Exploring young people's perspectives on mental health support: A qualitative study across three geographical areas in England, UK. Health & Social Care in the Community, 30(6), pp. e6366-e6375. https://doi.org/10.1111%2Fhsc.14078.

Lynch, L., Long, M. and Moorhead, A. (2018). Young men, help-seeking, and mental health services: Exploring barriers and solutions. American Journal of Men's Health, 12(1), pp.138-149. http://doi.org/10.1177/1557988315619469.

Mental Health UK. (2023). Available at: https://www.mentalhealth.org.uk/explore-mental-health/statistics/children-young-people-statistics (Accessed 15 January 2024)

NHS Digital. (2020). Mental Health of Children and Young People in England, 2020. Available at: https://files.digital.nhs.uk/AF/AECD6B/mhcyp_2020_rep_v2.pdf (Accessed 15 January 2024)

OReilly, M., Adams, S., Whiteman, N., Hughes, J., Reilly, P. and Dogra, N. (2018). Whose responsibility is adolescents mental health in the UK? Perspectives of key stakeholders. School mental health, 10, pp.450-461. https://doi.org/10.1007/s12310-018-9263-6.

Radez, J., Reardon, T., Creswell, C., Lawrence, P.J., Evdoka-Burton, G. and Waite, P., (2021). Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. European child & adolescent psychiatry, 30, pp.183-211. https://doi.org/10.1007/s00787-019-01469-4.

Appendices

Project proposal and Ethical approval form (Qualitative projects)

Data Management Plan