Barriers and Facilitators of Psychosocial Treatment Participation for Youth With Depression and Anxiety: A Scoping Review.

Depression and anxiety are prevalent mental health challenges experienced by youth and young adults; however, existing psychosocial interventions are not sufficiently effective. A growing body of research has examined the multiple factors that impact psychosocial treatment participation for youth with anxiety and depression. This scoping review uses the Health Belief Model (HBM) as a guiding framework to synthesize and categorize the factors that limit treatment participation (i.e., barriers) and those that are associated with greater treatment participation (i.e., facilitators) for youth aged 12-25 presenting to outpatient services for mood and anxiety difficulties. Abstracts and titles were reviewed for 5483 studies with 21 studies fitting full inclusion criteria. Most of the extracted factors fell within established HBM domains, with factors related to perceived barriers and severity most frequently reported. Relatively understudied areas included cues to action, perceived susceptibility, and self-efficacy. Also identified were multiple factors that serve as both barriers and facilitators depending on the context. The factors not captured by the HBM were socio-demographic factors and factors related to mental health service structure. Overall, this review aims to inform development of refined assessment and treatment approaches for youth with anxiety and/or depression at risk for early treatment termination.