International study reveals high unmet need for mental health care among adolescents in Asia and Europe

A large international study conducted at the University of Turku in Finland found that most adolescents do not seek professional help even when they have a high level of mental health problems. This unmet need was prevalent across all eight Asian and European countries involved in this study but especially in lower-income countries.

A new study revealed that even though many adolescents consider getting help or seek help from informal sources for their mental health problems, very few seek help from formal sources.

Doctoral Researcher Yuko Mori from the Research Centre for Child Psychiatry at the University of Turku, Finland, and the lead author of the study, tells that when adolescents attempt to get external help to deal with their mental health problems, there are two main types of help-seeking sources: informal and formal sources of help.

“Adolescents may get help from informal sources such as friends, teachers, and family members and/or formal sources such as school nurses, psychologists, and counsellors for professional assistance. Where they seek help from depends, for example, on the availability of services, cultural background, and stigma associated with mental illness”, Mori says.

Less than 1% of adolescents in middle-income countries seek professional help

The study included 13,184 adolescents aged 13 to 15 who completed self-administered surveys between 2011 and 2017 across eight Asian and European countries: China, Finland, Greece, India, Israel, Japan, Norway, and Vietnam. The study was conducted as part of the Eurasian Child Mental Health Study (EACMHS), a school-based cross-national study into the well-being and mental health of adolescents.

In middle-income countries, less than 1% sought help from professional sources while in high-income countries, this rate is slightly higher, between 2% and 7%. Girls are generally more likely to seek help for mental health problems than boys.

Only 1–2% of adolescents with a high level of emotional and behavioural problems in middle-income countries (India, Vietnam, China) sought formal help. In other words, 98– 99% of those who suffer from a high level of problems do not seek formal help. In high-income countries, the rate was significantly higher but still limited, 6–7% in Greece, Israel, and Japan and 21–25% in Norway and Finland respectively.

”Interestingly, significant difference between girls and boys on the unmet need were found only in Norway and Finland where girls were more likely to seek formal help than boys”, Mori notes.

Global need for mental health awareness and literacy programs

The study also revealed that informal sources of help are widely used among adolescents and are the key sources of help in many countries, particularly in lower-income countries.

The leader of the EACMHS, Professor Andre Sourander, MD says that the widely used informal sources of help especially in lower-income countries highlight a global need for mental health awareness and literacy programmes.

“Cross-cultural studies on adolescent mental health such as the present study are important because almost all mental health research comes from high-income Western countries. There is a huge knowledge gap because most research represents less than 10% of adolescent population. Maybe the most striking result was how important informal sources of help such as teachers, friends and parents were. This indicates worldwide importance of promoting culturally sensitive mental health awareness and literacy programs”, says Professor Sourander.

The research article “Unmet need for mental health care among adolescents in Asia and Europe” has been published in the European Child & Adolescent Psychiatry:

The study is part of the Inequalities, Interventions and New Welfare State Flagship INVEST, which focuses on reducing social inequality and reforming the welfare state. INVEST aims at providing Finland and other societies with a new model of welfare state that is more equal and economically, demographically and socially more sustainable. INVEST is a Research Flagship of the Research Council of Finland and a joint initiative of the University of Turku and the Institute for Health and Welfare THL.