Article summary with Mental health concerns and helpseeking behaviors among adolescents in high socioeconomic status groups: A scoping review by Matar et al. - 2023

Why is it important to examine the mental health risks for adolescents in high socioeconomic status groups?

There is a lot of research into the mental health of adolescents in low or medium socioeconomic groups, but there lacks information about those in high socioeconomic status groups. Mostly because it is believed that those adolescents have access to all kinds of protective factors. However, research shows that they are actually very similar to adolescents in low socioeconomic groups. They show externalizing problems, higher rates of major depressive disorder, and substance abuse. Understanding why they don’t seek help and what contextual factors are at play can help early intervention efforts and avoid a range of adverse outcomes.

Why do adolescents in high SES groups face barriers to help-seeking for mental health concerns?

Even though adolescents in high SES groups have greater access to health services and support, young people from low and medium SES groups engage more with health and school services. This may be due to a ¨culture of affluence¨. The unique social environment of adolescents in high SES groups might hinder help-seeking due to power, privilege, and stigma or shame about seeking help for mental illness.

How can the current theme be examined using Bronfenbrenner’s bioecological theory of human development and the help-seeking measurement framework?

Bronfenbrenner’s theory posits that an individual’s development is influenced by a series of interconnected environmental systems, ranging from the immediate surroundings to broad societal structures. Within the microsystem that surrounds them, adolescents experience a multitude of external and internal pressures. These stressors and other contextual factors within the microsystem may modulate the relationships between high SES and mental health.

What are the mental health concerns for adolescents in high SES groups?

Research shows significant mental health concerns related to substance use, externalizing and risk behaviors, bullying, depression, stress, and anxiety. Also, adverse and stressful life events, internalizing problems and prescription misuse. Adolescents in high SES groups engage in higher levels of alcohol use and intoxication, they have an earlier onset of drinking, and are more frequently intoxicated.

What factors other than family SES influence mental health concerns among adolescents in high SES groups?

Parents, neighborhood SES, school types, and peers play a crucial role. The parent-adolescent relationship especially had an influence. Excessive parental pressure to perform is associated with higher levels of depression, anxiety, and stress. It is possible that parental expectations to perform academically and other forms of parental criticism interfere with the development of identity and sense of self.

What is known about help-seeking behavior by adolescents in high SES groups?

The main sources of help-seeking for mental health were formal (e.g. school-based interventions) and informal (e.g. peers). The issues were usually bullying, anxiety, depression, and substance use. With regards to school or telephone services, there were no differences between adolescents from high SES groups and low/medium SES groups. But there were differences in health service use. This may be because there is a culture among high SES families that values privacy, deterring them from seeking help, especially when their parents hold powerful societal positions.