Stakeholder perspectives on mental health systems and services for emerging adults in Barbados

Emerging adulthood (ages 18-29) is a distinct developmental stage marked by significant psychological, social, and biological transitions, including identity formation, growing independence, and shifts in educational, employment, and relational roles. These increasing responsibilities and societal expectations heighten vulnerability to the onset or worsening of mental health challenges such as anxiety, depression, and substance use. Therefore, emerging adulthood is a critical period for mental health intervention. In Barbados, the post-pandemic period has seen a sharp escalation in mental health needs, particularly among young people, evidenced by a 100% rise in individuals seeking mental health services, increased demand for Community Mental Health services, and higher suicide rates alongside a surge in pandemic-exacerbated mental health cases. This study aimed to explore mental health systems and services for emerging adults in Barbados from the perspectives of local stakeholders (clients and providers of public, private, and NGO-based mental health services).

This qualitative exploratory study, grounded in an interpretivist paradigm, used purposive sampling guided by saturation. A semi-structured interview guide explored the interplay between individuals' mental health needs and the services provided. Seventeen interviews (30-45 min) were conducted with stakeholders recruited through gatekeepers in the governmental and non-governmental mental healthcare sectors. Interviews were conducted in person or via encrypted video conferencing, transcribed in a modified verbatim format, and analyzed using Hamilton's five-step Rapid Qualitative Analysis.

Four preliminary themes emerged from the data reduction process: "Perspectives on Mental Health and Mental Illness," "Framing Emerging Adulthood," "Health Service Needs," and "Facilitators and Barriers to Help-Seeking." These themes explicate how stakeholders conceptualize mental health and service use factors.

These insights highlight the pressing importance of implementing culturally relevant, developmentally appropriate mental health reforms that support emerging adults and strengthen their long-term resilience.