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Table 2 Barriers to and enablers of identification, treatment and on-going engagement

From: Primary care and youth mental health in Ireland: qualitative study in deprived urban areas

Theme Enabler Barrier
Identification of mental health and/or substance use problem in a young person • Outreach work • Prioritisation of crisis cases at the expense of early intervention
• Activity-based engagement • Confidentiality and consent issues, particularly around parental involvement for under 18s
• Mental health/drug awareness promotion • Concerns around formally treating a young person for a mental health or substance use problem
• Specific training in youth mental health/substance use problems  
• Experience in dealing with young people with mental health/substance use problems
• Using formal assessment tools
• Building a trusting relationship with the young person
Treatment of young person for mental health and/or substance use problem • A holistic/collaborative approach, including high quality communication, between healthcare agencies, e.g. primary care, secondary care and community-based agencies • Limited funding resources result in a lack of age-appropriate services
• Training for primary healthcare professionals, in particular, GPs in addressing youth mental health and substance use problems effectively. • Crisis intervention taking precedence over early intervention
On-going engagement • Intrinsic motivation of the young person • If young person is attending because of external pressure
• Continued/repeated opportunities for engagement • Unwillingness of some young people to attend counselling
• Personal achievement goals • Transition from child to adult services
• Having the structure of school or work to continue with during treatment or return to after treatment