Barriers and facilitators of mental health help-seeking behaviours among school-going adolescents in Sub-Saharan Africa: A qualitative evidence synthesis

TY - JOUR

T1 - Barriers and facilitators of mental health help-seeking behaviours among school-going adolescents in Sub-Saharan Africa

T2 - A qualitative evidence synthesis

AU - Kakinda, Adrian Ivan

AU - Croudace, Tim J

AU - Plouffe, Rachel A

AU - Amone- P'Olak, Kennedy

N1 - Publisher Copyright: © 2026 Cambridge University Press. All rights reserved.

PY - 2026/6/9

Y1 - 2026/6/9

N2 - Background: The prevalence of mental health problems (MHPs) among school-going adolescents in sub-Saharan Africa (SSA) remains high. However, help-seeking behaviours are disproportionately low in this population. This qualitative evidence synthesis (QES) aimed to identify and integrate existing qualitative findings on the barriers and facilitators of formal and informal MH help-seeking behaviours in this population. The objective was to generate insights from relevant studies and settings to inform the development of effective interventions for culturally grounded public mental health initiatives in schools in SSA. Methods: We conducted a systematic search across five databases (PubMed, CINAHL, Scopus, PsycINFO, ERIC, and Google Scholar) for qualitative studies published until September 2025. Eligible studies were appraised using the Critical Appraisal Skills Program (CASP) checklist. Thematic synthesis was employed to analyse and interpret the findings. Results: Twelve studies met the inclusion criteria. Six key barriers were identified: (1) perceived stigma, (2) gender norms as a barrier to help-seeking, (3) poor mental health knowledge, misconceptions, and awareness gaps, (4) privacy, trust, and confidentiality concerns with MH professionals, (5) lack of accessibility and availability of MH services, and (6) family and parental attitudes, peer influence, and alternative support. Facilitators included (1) mental health education and literacy enhancement, (2) supportive school environment or climate, (3) improved professional services, (4) family, community involvement, and peer support, and (5) improved service accessibility and affordability. Conclusions: This synthesis highlights the significant structural and sociocultural determinants of help-seeking behaviour in school-going adolescents in SSA. The scarcity of qualitative studies in this area underscores a critical gap in the existing literature. Further context-sensitive qualitative research is urgently needed to gain insights into adolescents’ lived experiences with MHPs and to guide responsive school-based mental health interventions.

AB - Background: The prevalence of mental health problems (MHPs) among school-going adolescents in sub-Saharan Africa (SSA) remains high. However, help-seeking behaviours are disproportionately low in this population. This qualitative evidence synthesis (QES) aimed to identify and integrate existing qualitative findings on the barriers and facilitators of formal and informal MH help-seeking behaviours in this population. The objective was to generate insights from relevant studies and settings to inform the development of effective interventions for culturally grounded public mental health initiatives in schools in SSA. Methods: We conducted a systematic search across five databases (PubMed, CINAHL, Scopus, PsycINFO, ERIC, and Google Scholar) for qualitative studies published until September 2025. Eligible studies were appraised using the Critical Appraisal Skills Program (CASP) checklist. Thematic synthesis was employed to analyse and interpret the findings. Results: Twelve studies met the inclusion criteria. Six key barriers were identified: (1) perceived stigma, (2) gender norms as a barrier to help-seeking, (3) poor mental health knowledge, misconceptions, and awareness gaps, (4) privacy, trust, and confidentiality concerns with MH professionals, (5) lack of accessibility and availability of MH services, and (6) family and parental attitudes, peer influence, and alternative support. Facilitators included (1) mental health education and literacy enhancement, (2) supportive school environment or climate, (3) improved professional services, (4) family, community involvement, and peer support, and (5) improved service accessibility and affordability. Conclusions: This synthesis highlights the significant structural and sociocultural determinants of help-seeking behaviour in school-going adolescents in SSA. The scarcity of qualitative studies in this area underscores a critical gap in the existing literature. Further context-sensitive qualitative research is urgently needed to gain insights into adolescents’ lived experiences with MHPs and to guide responsive school-based mental health interventions.

KW - School-going Adolescents

KW - mental health

KW - help-seeking behaviours

KW - Sub-Saharan Africa

KW - barriers

KW - facilitators

KW - qualitative evidence synthesis

UR - https://www.scopus.com/pages/publications/105041432632

U2 - 10.1017/gmh.2026.10250

DO - 10.1017/gmh.2026.10250

M3 - Article

SN - 2054-4251

VL - 13

JO - Cambridge Prisms: Global Mental Health

JF - Cambridge Prisms: Global Mental Health

M1 - e133

ER -