Family Predictors of Specialty Mental Health Service Use in Adolescents: A Prospective Cohort Study

One in seven adolescents has a mental disorder, accounting for 15% of the disease burden in this group. Identifying factors that are associated with adolescent help-seeking is essential for designing effective and sustainable mental healthcare. Family dynamics-particularly parental roles-are key determinants; however, these associations may evolve as adolescents become more independent. The present study aimed to identify family predictors of adolescents' use of specialized mental health services and to examine potential age effects. We addressed these aims by analyzing four waves of biennially collected data (ages 12-18) from two birth cohorts in Trondheim, Norway (n = 822), utilizing clinical interviews and questionnaires, and accounting for potential confounders. The results of an autoregressive cross-lagged panel model revealed that, across ages 12-18, adolescents' use of specialized mental health services at one time point consistently predicted continued use two years later. However, family functioning, parents' perception of social support, and interparental conflict did not predict service use when controlling for multiple potential confounders (including prior service use, gender, parental occupation, cohabitation status, parental depression and anxiety, perceived need for help, indicators of adolescents' emotional and behavioral problems, impairment, and stressful life events). The present findings indicate no evidence of a prospective association between these family factors and adolescents' receipt of mental-health services. Future research should investigate which specific factors drive help-seeking and how these interact within different service systems to support more sustainable and equitable access to mental health care.