Utilization of Health Services in Relation to Mental Health Problems in Adolescents: A Population Based Survey

Background: Only a minority of adolescents reporting symptoms above case-levels on screeningsfor mental health seeks and receives help from specialist health services. The objective of this studywas to a) examine help-seeking for symptoms of anxiety and depression in relation to symptomload dimensionally, b) identify the level of specialization in mental health among service-providers,and c) identify associations between mental health problems and contact with different types ofhealth services.Methods: This cross-sectional school-based study (response-rate 88%, n = 11154) is based onNorwegian health surveys among 15 and 16 year olds.Results: We found a dose-response association between symptom-load and help seeking. Only34% of individuals with mental symptom-load above 99th percentile reported help-seeking in thelast 12 months. Forty percent of help seekers were in contact with specialists (psychiatrists orpsychologists), the remaining were mainly in contact with GPs. Mental health problems increasedhelp seeking to all twelve service providers examined.Conclusion: It might not be reasonable to argue that all adolescents with case-level mental healthproblems are in need of treatment. However, concerning the 99th percentile, claiming treatmentneed is less controversial. Even in the Norwegian context where mental health services arerelatively available and free of charge, help-seeking in individuals with the highest symptom-loads isstill low. Most help seekers achieved contact with health care providers, half of them at a nonspecialized level. Our results suggest that adolescents' recognition of mental health problems orintention to seek help for these are the major "filters" restricting treatment.