Access to mental health support, unmet needs and preferences among adolescents during the first year of the COVID-19 pandemic

Introduction. The COVID-19 pandemic has had significant effects on the mental health of adolescents. However, little is known about support-seeking, unmet needs, and preferences for adolescent mental health care. Methodology. The Youth Development Instrument (YDI) is a survey of adolescents (N = 1928; mean age = 17.1; standard deviation [SD] = 0.3) in schools in British Columbia (Canada). We assessed, in the survey cohort, the characteristics of the mental health support resources consulted, the prevalence of unmet needs and the preference for services offered in person or services offered on the Internet. Results. Overall, 40% of adolescents said they had consulted a mental health support resource and 41% had their needs met. The support resources most often consulted were family physicians or pediatricians (23.1%) and adults at school (20.6%). The preferred mode of mental health care delivery for adolescents was face-to-face counseling (72.4%), followed by services offered via chat (15.0%), phone (8.1%) and call videos (4.4%). The adjusted prevalence of access to support was high among adolescents with anxiety (adjusted prevalence ratio [RPa] = 1.29; 95% confidence interval [CI]: 1.10 to 1.51) , adolescent alcohol users (RPa = 1.14; 95% CI: 1.01 to 1.29), gender minorities (RPa = 1.28; 95% CI: 1.03 to 1 .58) and sexual minorities (RPa = 1.28; 95% CI: 1.03 to 1.45). The adjusted prevalence of unmet needs was high among adolescents with depression (1.90; 95% CI: 1.67 to 2.18), adolescents with anxiety (RPa = 1.78; 1.56 to 2.03), adolescent girls (RPa = 1.43; 95% CI: 1.31 to 1.58), gender minorities (1.45; 95% CI: 1.23 to 1.70 ) and sexual minorities (RPa = 1.15; 95% CI: 1.07 to 1.23). Conclusion. Teens from a gender or sexual minority and teens with anxiety were more likely than others to have spoken about their concerns related to their mental health and also to have reported unmet needs. The most common sources of support were primary health care providers and adults in school, while the preferred mode of support was in-person services and the least preferred, video call services.