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Causal attributions and help-seeking is not well explored among adolescents, despite evidence of perceived causes for difficulties influencing how adults engage with treatment and seek help. This study reviewed extant literature to understand what adolescents at increased risk of developing mental health difficulties and those with clinically significant symptoms perceive to be the cause of emotional distress; to determine the extent to which perceived cause influences help-seeking; and to identify potential differences/commonalities between these groups. A systematic review and qualitative thematic synthesis were conducted. 3,691 articles were identified, 18 were eligible to be included and were synthesized using thematic synthesis. Six main themes related to perceived cause are reported. Three of those themes were shared between the clinical and at-risk groups: (1) challenging social factors and perceived difference, (2) problematic family dynamics, and (3) cause is complex and multifaceted. Three themes were not: (4) unfairness and perceived lack of agency and (5) concern for self and others, were exclusive to the at-risk group, and (6) coping with a mental health difficulty was exclusive to the clinical group. Four main themes related to causal attributions and help-seeking were found, including: (1) cause and implications for self-preservation; (2) the degree of personal and wider knowledge and understanding of cause; (3) perceived extent of control in managing cause; and (4) cause having potential to affect others. The findings of this review demonstrate that perceived cause for emotional distress plays a role in help-seeking among adolescent groups and highlights likely differences in how adolescents at-risk of mental health difficulties and those with clinically significant symptoms attribute cause for their difficulties and subsequently seek help. This has important implications for how to support young people experiencing or at risk of mental health difficulties and presents a strong case for pursuing more research in this area.

BackgroundFor older adolescents, the COVID-19 pandemic and associated UK restrictions have arrived during a critical period in the transition to adulthood, and early research exploring impact of the pandemic paints a picture of worsened adolescent wellbeing and mental health. We set out to explore the subjective experiences of 16- to 19-year-olds during the first UK lockdown, with a particular emphasis on wellbeing and coping, in order to complement emergent quantitative evidence and inform strategies and provision for support.MethodsIn May 2020, we invited 16- to 19-year-olds based in the UK to share their experiences of the initial lockdown as part of ‘The TELL Study’. A total of 109 participants took part, submitting anonymous written accounts of their experiences via an online portal. We used reflexive thematic analysis to explore these accounts and develop rich experiential themes.Findings: We constructed seven main themes: heightened emotionality; feelings of loss, change, and uncertainty; recognising the value of self-care; efforts to think positively; opportunities for growth and development; the importance of togetherness; and frustration with government and media.ConclusionsFindings shed light on the emotional impact of lockdown and the concerns it has raised for older adolescents and offers insight into ways that they have been coping and working to stay connected. The study highlights directions for support and provision for adolescents in facilitating positive wellbeing and resilience as the consequences of the pandemic continue.

For older adolescents, the COVID-19 pandemic and UK restrictions arrived during a critical period in the transition to adulthood. Early research exploring impact of the pandemic paints a picture of worsened adolescent wellbeing and mental health. We explore the subjective experiences of 16- to 19-year-olds during the first UK lockdown, with an emphasis on wellbeing and coping, to complement quantitative evidence and inform strategies and provision for support. In May 2020, we invited UK-based 16- to 19-year-olds to share written accounts of their experiences of the initial UK lockdown for The TELL Study. A total of 109 participants engaged, submitting anonymous written accounts via an online survey portal. We used inductive reflexive thematic analysis to develop rich experiential themes. We constructed seven main themes: heightened emotionality; feelings of loss, change, and uncertainty; recognizing the value of self-care; efforts to think positively; opportunities for relief, growth, and development; the importance of togetherness; and frustration with government and media. Findings highlight the multifaceted nature of adolescents’ lockdown experiences, and offer insight into emotional impact and new concerns alongside the value placed on self-care and staying connected. We offer directions for supporting adolescents as pandemic consequences continue.