Does the quality of the relationship to parents and peers predict mental health service use during adolescence? A prospective community study.

Adolescents frequently seek emotional support from parents and peers when experiencing psychological distress. The quality of these relationships may therefore influence their help-seeking behavior and access to professional care, but it is yet unknown whether the quality of the relationship to parents and peers prospectively predict adolescent mental health service use. Guided by the Behavioral Model of Health Service Use, the present study examined whether perceived relationship quality-specifically closeness and conflict with mother, father, and best friend-prospectively predicted use of specialty mental health services. Data were drawn from a Norwegian birth cohort assessed from ages 12 to 18 across four waves (n = 822), using clinical interviews and questionnaires. Results from an autoregressive cross-lagged panel model including a propensity score of potential confounders (prior service use, gender, parental occupation, cohabitation status, parental depression and anxiety, perceived need for help, symptoms of adolescents' emotional problems and disruptive behaviors, impairment, and stressful life events) showed that higher conflict with father predicted lower subsequent service use across age. Other relationship factors (i.e., closeness with father, as well as closeness and conflict with mother and best friend) were unrelated to service use. These findings suggest that father-adolescent conflict may be associated with lower use of specialty mental health services among adolescents and warrant further investigation of the role of fathers in adolescents' help-seeking.