"When you're in the office, it means you managed to get somewhere": An interpretive descriptive study of the perceptions of adolescents accessing primary care for mental health services.

Objective: Primary care offers an entry point into the health care system for adolescents experiencing mental illnesses. This study explored the perceptions of adolescents with an anxiety or mood disorder accessing primary care for mental health services. Methods: Qualitative interpretive descriptive design was employed. Participants ages 15-18 years (n = 10) were recruited from a mid-sized city in Canada utilizing flyers and social media advertisements. Data were collected between August and December 2019. Data generation methods included photo-elicitation, demographic survey, and semi-structured interviews. Analysis was guided by a health care access framework and ecological model. Results: Adolescents perceived the process of accessing primary care for mental health services as complex and beginning prior to entering the primary care environment; a novel conceptual framework was developed to depict the process. Adolescents described three stages in this process: feeling uncertain about their concerns and requiring help; seeking informal support from parents and friends to initiate help-seeking; and receiving mental health services through primary care. Discussion: A novel conceptual framework to depict the process of access for adolescents is proposed. Primary care practitioners require awareness of the access process adolescents conceptualize prior to deciding to seek help in primary care, as well as the need to foster their emerging adulthood in care. Targeted interventions to enable early intervention include providing information about mental health services available during routine interactions.