Scoping Review: Perceived Needs, Barriers, Facilitators, and Satisfaction With Access and Utilization of Mental Health Services Among Rural Adolescents and Parents in the United States.

Objective: Adolescents in rural communities in the United States experience significant disparities in mental health service access and utilization. To inform service development and expansion, this scoping review identified the self-reported needs, barriers, and facilitators to accessing and using mental health care services of rural adolescents (ages 12-18) and parents and their satisfaction with services received. Method: Following a preregistered protocol, 14 databases and repositories were searched from database inception to the present. Records underwent dual screening and extraction, with disagreements resolved by consensus. Studies on US-based rural adolescents and/or parents that identified perceived needs, barriers, facilitators, and service satisfaction were included. Results: Of 6,437 citations, 70 studies met the inclusion criteria. Service needs/preferences were reported for location and provider type (n = 22), specific treatment targets and delivery models (n = 19), service quality (n = 16), and supports for accessing care (n = 10). Barriers to service access/utilization were identified for service accessibility (n = 27), stigma/negative beliefs (n = 26), service quality (n = 12), and social barriers (n = 6). Youth and parents reported interest in settings, providers, and types of supports that are outside of traditional mental health service settings. They expressed interest in greater use of telehealth and availability of preventive interventions. Youth reported a need for services for depression and anxiety, parents requested parenting support, and both indicated a need for more services for substance use disorders. Families of minoritized backgrounds identified needs for culturally relevant services, multilingual providers, and providers with shared identities. Conclusion: This review curates a list of US-based rural adolescents' and parents' self-reported needs, barriers, and facilitators for access to inform service quality improvement and future research. Study registration information: Perceived needs, barriers, and facilitators to accessing mental health care among rural adolescents and their caregivers: A scoping review; https://osf.io/3unfv.