Barriers to accessing psychotherapeutic care among young adults: Individual and regional associated factors

Abstract

Background: Mental health problems are widespread among young adults in Germany, yet the use of professional help remains low. This study aimed to identify the most common perceived barriers to help-seeking and to examine which individual and regional factors are associated with unmet need for mental health care. Methods: A total of 3,051 former participants of the KiGGS cohort study (aged 16 to 25 years) took part in an online survey. Group comparisons and regression analyses were conducted to examine associations of individual and regional characteristics with unmet need for care. Results: Overall, 42.6 % of respondents reported not having used professional help despite being advised to do so or perceiving a need themselves. The most frequently reported barriers were difficulties in acknowledging one’s own need for help (problem denial) and negative attitudes towards seeking professional help (help-seeking stigma). Within this group, unmet need was more likely reported by women, individuals with lower subjective social status, depression or anxiety symptoms, low mental health-related quality of life, or inadequate health literacy. Regional characteristics such as the density of care provision or socioeconomic deprivation were not significantly associated with unmet need. Conclusions: The findings highlight the importance of subjective barriers to help-seeking behaviour. Low-threshold interventions may help improve self-awareness, appraisal competence, and openness in dealing with psychological distress, thereby reducing the risk of mental health disorders.