Use or no use? Young People's engagement with mental health services

Mental health challenges among young people are a significant concern in the United Kingdom, with an estimated 16 % of young people experiencing common mental health problems like anxiety and/or depression on any given day, yet only one in four of these are able to access mental health services. This study seeks to identify the key determinants influencing young people's mental health care utilization and to examine the experiences faced by those who do not engage with mental health services, using a co-produced adaptation of Andersen's Behavioral Model of Health Care Utilization to analyze linked health care data from the NEXT STEPS cohort. Imputation addressed missing data, while logistic regression assessed need, enablers, and predispositions influencing care use. Key findings indicate that young people's mental health care utilization is primarily driven by clinically assessed need, while factors such as female gender, presence of psychiatric-level symptoms, limited social support, external locus of control, parental unemployment emerged as weaker predictors of service engagement. Young people with common mental health problems who had not accessed mental health services were less likely than service users to be female, live in single-parent households, have caring responsibilities, or report bullying, but were more likely to report positive parental relationships. Adults who had accessed mental health services as a young person experienced less favourable adult outcomes and quality of life relative to non-users. These findings highlight the need to reform youth mental health care models towards more inclusive, preventative, and holistic approaches.