title: Young people with depression and their experience accessing an enhanced primary care service for youth with emerging mental health problems: a qualitative study.
abstract: BACKGROUND
  Despite the emergence of mental health problems during adolescence and early adulthood, many young people encounter difficulties accessing appropriate services. In response to this gap, the Australian Government recently established new enhanced primary care services (headspace) that target young people with emerging mental health problems. In this study, we examine the experience of young people with depression accessing one of these services, with a focus on understanding how they access the service and the difficulties they encounter in the process.
  
  
  METHODS
  Individual, in-depth, audio-recorded interviews were used to collect data. Twenty-six young people with depression were recruited from a headspace site in Melbourne, Australia. Interpretative phenomenological analysis was used to analyse the data.
  
  
  RESULTS
  Four overlapping themes were identified in the data. First, school counsellors as access mediators, highlights the prominent role school counsellors have in facilitating student access to the service. Second, location as an access facilitator and inhibitor. Although the service is accessible by public transport, it is less so to those who do not live near public transport. Third, encountering barriers accessing the service initially. Two main service access barriers were experienced: unfamiliarity with the service, and delays in obtaining initial appointments for ongoing therapy. Finally, the service's funding model acts as an access facilitator and barrier. While the model provides a low or no cost services initially, it limits the number of funded sessions, and this can be problematic.
  
  
  CONCLUSIONS
  Young people have contrasting experiences accessing the service. School counsellors have an influential role in facilitating access, and its close proximity to public transport enhances access. The service needs to become more prominent in young people's consciousness, while the appointment system would benefit from providing more timely appointments with therapists. The service's funding model is important in enabling access initially to young people from low socioeconomic backgrounds, but the government needs to reassess the model for those who require additional support.
authors.affiliation: School of Nursing and Midwifery, Victoria University, PO Box 14428, Melbourne, 8001, VIC, Australia. terence.mccann@vu.edu.au
authors.forename: Terence V
authors.initials: TV
authors.lastname: McCann
authors.forename: Dan I
authors.initials: DI
authors.lastname: Lubman
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D003376:Counseling; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008603:Mental Health; D008605:Mental Health Services; D011320:Primary Health Care