Research shows that young people around the world are at high risk of mental health problems. At the same time, they often face poor access to timely and appropriate care. This mismatch between need and support is called the treatment gap. The result? Many young people go without help for too long, and their problems grow, with serious impact on their health and future.
These findings come from the 2022 study by Thérèse van Amelsvoort and Sophie Leijdesdorff: “Peer involvement and accessibility as key ingredients for 21st century youth mental health care services.” Their research looks at the position of young people in mental health care — and calls for a major rethink of how that care is organised.
The researchers build on the work of McGorry and his colleagues, who have long highlighted the importance of accessible, low-threshold support. Together, they show that young people don’t just need help, they should also have a say in what that help looks like.
The impact of the corona pandemic
The COVID-19 pandemic made this need even more urgent. According to the researchers, the pandemic is the biggest threat to mental health since World War II.
Young people were hit especially hard. Reports of loneliness, suicidal thoughts and referrals to specialist care increased. More students also dropped out of education, with possible consequences for their future.
Impulse digitalization
Crisis periods can also spark new ideas. During the pandemic, the digitalisation of society accelerated, bringing digital care solutions closer, like mHealth tools that support young people through apps or online platforms. These forms of support are transdiagnostic (not tied to one specific diagnosis), low-threshold, and tailored to a generation raised in a digital world.
Why access is so important
One of the biggest challenges is still access to care. Despite efforts over the past ten years, it remains difficult to reach young people, especially those at higher risk of mental health problems.
McGorry and his colleagues point out that this is partly due to how traditional care is organised. Young people face multiple barriers when they try to seek help:
- Stigma and shame
- Concerns about costs
- Limited knowledge of mental health problems
- Long waiting lists
- Not knowing where to go
These barriers mean many young people don’t ask for help until things have already become serious. The time between first symptoms and actual contact with support can take years. Professionals often only see that starting point, not the long road a young person has already travelled to get there.
Early intervention is needed
To enable earlier intervention, access to care must be improved. McGorry and colleagues identify three key points:
- Co-design, involving young people in designing care
- Peer involvement, the use of peers
- Soft entry, an accessible first step towards help
Peer support, support from peers or youth volunteers, is, according to them, a valuable innovation.
The value of peer support
In many countries, peer support is mainly seen as a cheap solution in situations with a shortage of professionals. However, Van Amelsvoort and Leijdesdorff emphasise that it is more than that. They argue that peer support should be a crucial part of youth care.
Young people often feel more comfortable talking about sensitive topics with peers. This could be about suicidality, anxiety, or sexual abuse. Peer support lowers the threshold, and can support recovery. Research shows that peer support helps young people move forward, both in measurable (quantitative) and personal (qualitative) ways
For proper implementation, certain conditions are necessary:
- Clear agreements about the role of peer workers and professionals
- Sufficient training and guidance
- A close connection with the rest of the healthcare system
First stop instead of one stop
According to the researchers, it’s not realistic to offer full mental health services at every youth walk-in centre. In fact, that could raise the threshold. That’s why they prefer the term “first-stop shops” instead of “one-stop shops.”
A first-stop is a place where young people can walk in easily and have an initial conversation. From there, you look together at what next steps make sense for that young person. Which services are involved should be decided regionally — based on what’s available locally and what young people actually need.
More research and changes in attitude
The researchers stress that more research is needed into the value of peer support. Both qualitative and quantitative studies are important to better understand how peer support improves access to care and makes it more effective.
A mindset shift is also needed among professionals. It’s not just the system that has to change, it’s also about how people in that system work and think. Input from young people is key: they know what’s needed and can point out what professionals often miss.
Collaboration between domains
Mental health problems in young people often coincide with problems in other areas, such as school, work, or home. Therefore, the authors advocate for a multidisciplinary approach.
This means collaboration between healthcare, education, and social services. The design of accessible care must be broadly approached, with attention to all aspects of young people’s lives.
Conclusion
Young people urgently need accessible and forward-thinking mental health care. Peer support and low-threshold access aren’t optional extras, they’re essentials in modern youth support.
De onderzoekers benadrukken dat jongeren vaak al een lange weg achter de rug hebben voordat zij bij de hulpverlening binnenstappen. Door in te zetten op peer support, co-design en first-stop centra kan die weg korter, begrijpelijker en beter worden gemaakt.
Curious about all the results?
You can read the full scientific article here, titled “Peer Engagement and Accessibility as Key Ingredients for Youth Mental Health Care in the 21st Century.”
Do you have questions about our scientific research? Feel free to contact us; we’d be happy to tell you more.