Abidin Early Career Award Update

Abidin Early Career Award Update

By Jessica L. Schleider, PhD
2021 Abidin Award Winner

By Jessica L. Schleider, PhD
2021 Abidin Award Winner

The Abidin Award has served as a powerful accelerator for our lab’s research on single-session youth mental health interventions—and in particular, in understanding access barriers and service preferences and needs among U.S. adolescents facing structural barriers to treatment. With support from this Award, we conducted a series of exploratory qualitative studies, leveraging a participant pool from an RCT of self-guided single-session interventions for adolescent depression (N = 2,452 adolescents with elevated depression symptoms, across all 50 US states; 80% LGBTQ+ youth, 50% racial/ethnic minority youth; Schleider et al., 2022, Nature Human Behaviour). Approximately six months after the final follow-up for this RCT, we invited all previous participants to take part in an additional, qualitative survey study, yielding a sub-sample of 281 adolescents. We have now completed four mixed-methods research projects using these data, each of which was pre-registered on Open Science Framework (https://osf.io/p3hj4). Results of these projects—which collectively shed light on youths’ preferences for and barriers to accessing mental health services —are summarized below.

Table 1. Demographics for full participant pool

Study 1: A Mixed-Methods Investigation of Adolescent Comfort in Mental Health Disclosure with Parents. 

Overview and goals. The goal of this study was to identify the barriers adolescents reported facing when attempting to access desired mental health services.

Key study results. Overall, 13 barriers were identified through thematic analysis, and youth reported an additional 25 unique barriers best described as “other,” which highlights the complex nature of the challenges adolescents face when trying to access mental health support. Among the barriers endorsed, financial concerns and family related issues emerged as the most prevalent barriers, as 42.48% (n=52) of participants endorsed family-related barriers and 31.71% (n=39) of participants endorsed finance-related concerns. This study highlights the need to amplify youths’ voices to reduce barriers to care for adolescents who want it; namely, addressing financial concerns and family-related barriers may be particularly important.

Scientific outputs to date:

Peer-reviewed manuscript: Roulston, C. A., Ahuvia, I., Chen, S., Fassler, J., Fox, K., & Schleider, J. L. (in press). “My family won’t let me.” Adolescent-reported barriers to accessing mental health care. Journal of Research on Adolescence. Preprint: https://osf.io/preprints/psyarxiv/yqgh3_v2

Study 2. A Mixed-Methods Investigation of Adolescents’ Comfort Disclosing Mental Health Concerns to Parents.

Overview and goals. The study aimed to understand what factors relate to adolescents’ willingness to discuss their mental health needs with their parents, and how these factors related to demographic and symptomology-related variables.

Key study results. Nine themes emerged from thematic analysis, and the three most frequent were “Internalized Fear” (29.4%), “Mental Health Literacy” (21.3%), and “Blew off” (17.7%). On a 5-item measure ranging from not at all to completely comfortable, adolescents rated lower comfortability and willingness to discuss their mental health needs with parents (M = 2.4, SD = 1.2). This study highlights a need to support factors that may promote adolescent comfortability in talking about mental health such as combating stigmatizing thoughts impeding disclosure, improving parent mental health literacy, and giving adolescents who do not feel safe or comfortable discussing their mental health with parents a way to independently access care.

Scientific Outputs to Date:

• Paper in progress: Smock, A., Hill, S., Szkody, E., Fox, K., & Schleider, J. L. (in preparation). A Mixed-Methods Investigation of Adolescent Comfort in Mental Health Disclosure with Parents.

Study 3. Ideal mental health supports for adolescents: A mixed-methods analysis.

Overview and goals. Understanding how well youths’ preferences are aligned with existing digital mental health supports can inform future efforts to expand access to sustainable support. This study explored support preferences among youth who recently engaged with digital mental health support.

Key study results. Most youth would involve a professional in their ideal mental health support, and most youths’ ideal mental health support would take place in-person, although many youth noted high interest in digital mental health tools, as well. Overall, youth would have more control over their ideal mental health support; nearly 70% of youth expressed they alone would decide whether their ideal support was working. By contrast, between 5-6% of youth reported their parent(s) would help decide if their ideal support was working. A substantial minority of youth expressed explicit concerns about involving their parents. Meeting the wide range of needs and preferences among youth requires a diverse ecosystem of accessible mental health support options.

Scientific outputs to date:

• Study 3 of the linked dissertation (by Mallory Dobias, PhD), manuscript to be submitted for publication: Dobias, M.L., Roulston, C., Jans, L., Ahuvia, I., & Schleider, J.L. (in preparation). Ideal mental health supports for adolescents: A mixed-methods analysis.
• Conference Talk: Dobias, M.L., Roulston, C., Jans, L., Ahuvia, I., & Schleider, J.L. (2023, November). Mixed methods analysis of youth mental health support preferences. Symposium presented for the 57th Annual Association for Behavioral and Cognitive Therapies Convention, Seattle, WA.

Study 4: A Mixed-Methods Investigation of Adolescents’ Beliefs About the Causes of Depression. 

Overview and goals. This study investigated adolescents’ causal beliefs about depression, with a goal of understanding how these beliefs relate to help-seeking, treatment preferences, and clinical outcomes.

Key study results. The most common causal beliefs were dysfunctional home and family relationships (52%) and stress from school (42%). Several causal beliefs were expressed more in regard to one’s own depression than others’ depression (e.g., adverse childhood events, 11% vs. 3%, p = .004) and vice versa (e.g., social media use, 12% vs. 2%, p < .001). Few significant relationships emerged between causal beliefs and demographic and clinical variables. Adolescents’ causal beliefs about depression are diverse and multifaceted, and their causal beliefs endorsed about their own depression differ substantially from those endorsed about depression generally.

Scientific outputs to date:

• Peer-reviewed manuscript: Ahuvia, I., Chen, S., Gordon, L., Fox, K., & Schleider, J. (2024). A Mixed-Methods Investigation of Adolescents’ Beliefs About the Causes of Depression. Journal of Adolescent Research. Advance online publication. https://doi.org/10.1177/07435584241256605
• Plenary Talk: Ahuvia, I., Chen, S., Gordon, L., Fox, K., & Schleider, J. (2023, April). A Mixed-Methods Investigation of Adolescents’ Beliefs About the Causes of Depression. Hughes Fellowship plenary presentation given at the Society for the Study of Psychiatry and Culture Annual Conference, San Diego, CA.
• Conference Talk: Ahuvia, I., Chen, S., Gordon, L., Fox, K., & Schleider, J. (2023, November). Adolescents’ Beliefs About What Causes Depression: Implications for Clinical Psychoeducation. Symposium presentation given at the Association for Behavioral and Cognitive Therapies Annual Convention, Seattle, WA.