Characterizing unmet mental health need and barriers to seeking services among youth.

Youth experience a high burden of distress, yet little is known about how unmet mental health needs and barriers to seeking services vary across different subgroups. This study explored how unmet needs and barriers to seeking support varied by sociodemographic characteristics and distress. Using data from the 2023 Ontario Student Health and Drug Survey (OSDUHS), logistic regression models and interaction terms examined the associations between sociodemographic characteristics, distress, unmet need and barriers among students in grades 7 through 12. Approximately one-third of students reported needing but not seeking support. Unmet need was more common among females, secondary students and those with higher distress. The most frequently reported barrier was thinking they could manage it alone (67%), with significant variation in other barriers by gender, distress, and ethnoracial background. Youth with serious distress were more likely to report multiple barriers. Tests of the interaction between distress and ethnoracial background found that South Asian youth with low distress were at higher odds than other ethnoracial groups of endorsing the belief that help would not be effective as a reason for not seeking services. There were no significant interactions for other barriers. This study underscores the need for equity-informed, culturally responsive strategies to enhance access to mental health services.