Barriers to Young People Seeking Help for Trauma: A Qualitative Analysis of Internet Forums

Clinical Impact Statement Young people affected by trauma experienced internal, psychological barriers to help-seeking. Many of these barriers were related to the effects of trauma, such as avoidance of trauma memories, lack of self-worth, a sense of hopelessness and helplessness, and lack of trust in others. Others were related to fear of losing control of disclosed information about the trauma they had experienced and having confidentiality broken. Services can seek to reduce these barriers by providing information about their confidentiality processes and psycho-education about the impact of trauma in online resources about their services and outreach activities. Objective: Exposure to trauma is common in childhood and adolescence and is associated with significant psychopathology. Despite being amenable to treatment, many young people suffering trauma-related distress do not disclose or seek help. Multiple barriers to young people help seeking for mental health concerns have been identified, but very little research has focused on help seeking after trauma exposure. We undertook a qualitative analysis of Internet forums in which young people discuss trauma, aiming to understand the barriers preventing them from disclosing and seeking help offline. Method: Posts about trauma written in 2016 from five Internet forums targeting young people were analyzed by thematic analysis. Results: Barriers to offline help-seeking for trauma aligned with five key themes: questioning the validity of the trauma response; negative emotions and beliefs about the self; fear of a negative response; difficulties trusting others; and not thinking or talking about the trauma. Conclusions: Young people conceptualized many barriers as consequences of the trauma, such as avoidance of the trauma memory, and difficulties trusting others, indicating there are trauma-specific barriers to help-seeking. Understanding of, and attempts to minimize, these barriers may facilitate provision of services to vulnerable young people.