Adolescent mental health problems are increasing globally, emerging during a developmental period marked by shifts in social relationships, identity formation, and growing autonomy in health behaviors. Although adolescents may access both formal and informal sources of support, many refrain from seeking support due to a range of individual and structural barriers. A deeper understanding of the social processes involved in help-seeking in adolescence is needed, particularly regarding the role of emotional connectedness and how it relates to the help-seeking process. The aim was to explore adolescents’ perceptions of how emotional connectedness influences help-seeking for mental health problems. Twenty-four adolescents, aged 15, from two schools in the south-west part of Sweden, agreed to participate in focus group interviews. A Situational Analysis was carried out in multiple steps. The results show thatemotional connectedness, distinguished through emotionally close or distant relationships, either facilitated or hindered help-seeking intention based on how the relationships were perceived and what struggles were discussed. Emotional closeness represented something secure and predictable, but could be perceived as conditional and burdensome related to help-seeking. Emotional distance could be perceived as unconditional and alleviating, thus, facilitating help-seeking, but was also ascribed to relationships where help-seeking felt insecure and unpredictable. In conclusion, depending on the context, both emotional closeness and distance may facilitate or hinder help-seeking. The dual meaning of emotional connectedness in relation to help-seeking warrants further investigation. © 2026 Häggström Westberg et al.

Health is multifaceted, with divergent interpretations in diverse cultures and groups of individuals. The ways individuals understand health might aid in developing future interventions. There is scant knowledge on how adolescents with depression conceptualise health. A descriptive qualitative design with a phenomenographic approach was used to describe the different ways adolescents with depression conceptualise health. Interviews were performed with adolescents 13–17 years old (n = 33) who participated in a randomised controlled trial evaluating the effects of aerobic group exercise versus leisure group activities for adolescents with depression. The results were interpreted into four metaphors to embody the understanding of health as described by adolescents with depression: 1) establishing sound routines by managing everyday life, 2) connecting to others by having access to social resources, 3) managing depression symptoms by having control over the mental illness, and 4) attaining inner drive by experiencing joy in everyday life. The various conceptions of health among adolescents with depression provide valuable insights for enhancing evidence-based treatments with person-centred care. Key aspects include establishing routines, fostering connections, finding strategies for symptom control, and incorporating joy through exercise. Given that adolescents highlighted these aspects as essential to health, future research could explore individualised health promotion, particularly focusing on routine-building, social connections, or finding an inner drive as an add-on to evidence-based treatments for adolescent depression. © 2025 Danielsson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 

Background: Globally, young adults with mental health problems struggle to access appropriate and timely care, which may lead to a poorer future prognosis. Artificial intelligence (AI) is suggested to improve the quality of mental health care through increased capacities in diagnostics, monitoring, access, advanced decision-making, and digital consultations. Within mental health care, the design and application of AI solutions should elucidate the patient perspective on AI. Objective: The aim was to explore the perceptions of AI in mental health care from the viewpoint of young adults with experience of seeking help for common mental health problems. Methods: This was an interview study with 25 young adults aged between 18 and 30 years that applied a qualitative inductive design, with content analysis, to explore how AI-based technology can be used in mental health care. Results: Three categories were derived from the analysis, representing the participants’ perceptions of how AI-based technology can be used in care for mental health problems. The first category entailed perceptions of AI-based technology as a digital companion, supporting individuals at difficult times, reminding and suggesting self-care activities, suggesting sources of information, and generally being receptive to changes in behavior or mood. The second category revolved around AI enabling more effective care and functioning as a tool, both for the patient and health care professionals (HCPs). Young adults expressed confidence in AI to improve triage, screening, identification, and diagnosis. The third category concerned risks and skepticism toward AI as a product developed by humans with limitations. Young adults voiced concerns about security and integrity, and about AI being autonomous, incapable of human empathy but with strong predictive capabilities. Conclusions: Young adults recognize the potential of AI to serve as personalized support and its function as a digital guide and companion between mental health care consultations. It was believed that AI would function as a support in navigating the help-seeking process, ensuring that they avoid the “missing middle” service gap. They also voiced that AI will improve efficiency in health care, through monitoring, diagnostic accuracy, and reduction of the workload of HCPs, while simultaneously reducing the need for young adults to repeatedly tell their stories. Young adults express an ambivalence toward the use of AI in health care and voice risks of data integrity and bias. They consider AI to be more rational and objective than HCPs but do not want to forsake personal interaction with humans. Based on the results of this study and young adults’ perceptions of the monitoring capabilities of AI, future studies should define the boundaries regarding information collection responsibilities of the health care system versus the individuals’ responsibility for self-care. © Lena Petersson, Mikael G Ahlborg, Katrin Häggström Westberg.

BACKGROUND: Help-seeking for mental health problems is a complex process that involves handling both personal challenges and dealing with the organizational structure of the healthcare system. The healthcare system is siloed and fragmented, but it is unclear how the challenges are experienced by the young adults and what their healthcare journeys look like. Therefore, the aim of this study was to explore experiences of young adults' healthcare journeys in the context of help-seeking for common mental health problems.

METHODS: In total, 25 young adults (16 women and 9 men) from a student healthcare centre at a Swedish university seeking help for common mental health problems, such as anxiety and depression, were interviewed. A qualitative thematic analysis with an inductive approach was done, and results were abstracted and presented in terms of journey-related metaphors.

RESULTS: The healthcare journeys of young adults were described as Taxi Riding, Commuting, Sightseeing, and Backpacking. Taxi riding and Commuting are defined by going in a straightforward and smooth way in the healthcare system, without major obstacles to care. In contrast, Sightseeing and Backpacking are characterized by more diffuse and negative experiences, where the young adults are not satisfied with the help received from healthcare providers. Help-seeking is not conformant with the design of the healthcare system but steered by a range of factors, including individual experiences and young adults' agency, the available resources at the various healthcare providers, and interaction with healthcare professionals.

CONCLUSIONS: Young adults' healthcare journeys in the context of help-seeking for common mental health problems are related to individual, relational, and organizational factors. Some journeys run smoothly, epitomizing a functioning healthcare system that accommodates a rational help-seeker. Other journeys depict a rigid healthcare system, where the success and nature of the journey primarily depend on individual agency and on not becoming discouraged by obstacles. There is a need for more knowledge on how to support young adults' mental health help-seeking. However, we also need more insights into how the healthcare system can become more receptive and accommodating toward the needs of young adults with common mental health problems. © The Author(s) 2025.

Rationale: Novel strategies are needed to address the public health priority of strengthening youth mental health. Social capital is considered an important determinant of mental health among youths, connecting the individual to their social environment. Social capital can be seen as a valuable asset that can help guide youths during challenging times and help them sustain a balanced mental health. As adolescents navigate their social environments, the connections they establish and the networks they engage with might serve as crucial determinants shaping their attitudes and behaviours towards seeking help. Bonding relationships offer support and foster mental health awareness, while the structure of the social network determines which resources and guidance that are accessible. Help-seeking competency may be nurtured by creating a social environment supportive of open discussions about mental health. Consequently, youths with higher levels of social capital might find seeking help a more viable and normative course of action. Gaining a deeper knowledge on how social capital connects to help-seeking in relation to mental health aligns with the broader aspiration of ensuring that youths receive timely and appropriate support. 

Objectives: The overall aim of this project is to investigate social capital in relation to help-seeking and mental health in close collaboration with youths and key stakeholders in the southern part of Sweden. The following research questions will be explored:

·       What is the role of social capital for youth mental health? 

·       How does social capital shape youths’ help-seeking and the social pathways leading to timely intervention and support the help-seeking process? 

·       How can the knowledge generated throughout the project be translated into practice?  

Methods: This project is ongoing and in the phase of instrument development in collaboration with youths, 15 years old. Then, about 800 youths, aged 15, will be followed over time in school settings that represents rural and urban parts of southern Sweden. The newly developed and validated instruments on social capital and help-seeking respectively will be used in a longitudinal questionnaire study along with self-reported mental health. A collaborative process that involves youths and stakeholders takes place during the project to ensure relevance and applicability of the findings. 

Results: Two newly developed and validated instruments will be presented, one instrument that captures social capital as youths have described it and one instrument that captures the complexity of mental health help-seeking of youths today. We also expect to present preliminary results on the role of social capital for youths’ mental health and how this is linked to help-seeking. 

Policy implications: The project promotes collaborative work, involving youths and stakeholders, where knowledge, different perspectives and experiences are shared to discuss the practical implications of the project, short- and long term, and help bridge the gap between research and practice. 

Conclusions: Our hope is that this project will increase our knowledge on the social dimension of mental health in the adolescent population and generate practical implications that will help adolescents to thrive. 

Aim: The aim of this integrative review was to investigate how resilience has been researched and explore experiences of resilience, in children of parents with mental illness or alcohol or substance misuse. Design: An integrative review. Method: The search included three major electronic databases, PubMed, Scopus and PsycINFO with the aim of identifying peer-reviewed studies where the concept of resilience was explored as resilience, coping, adaptation or protective factors. Results: Out of 4016 studies, 14 were included after meeting predetermined criteria and methodological quality evaluation. The findings are presented in five categories: characteristics of the studies, operationalization and interpretation of resilience, individual resources, family resources and resources outside the family. Patient or public contribution: Resilience in children of parents with mental illness or substance misuse refers to coping strategies, protective factors and absence of symptoms or risk behaviour despite being exposed to risk. We suggest a three-level approach for mapping of resilience resources in the target group: the individual level, family level and outside of the family that includes both non-professionals and professionals. The use of disengagement or avoidance strategies implies poor resilience but may be necessary in absence of support, as acts of self-preservation during chaotic periods or harmful situations. © 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.

Background: The increase in adolescents reporting mental health problems presents a major public health challenge. The complex association between mental health and social capital motivates further investigation of social capital as a crucial aspect in shaping adolescents' help-seeking knowledge, attitudes, and behaviours. Aim: This protocol presents a project that aims to investigate social capital in relation to help-seeking and mental health in close collaboration with adolescents and key stakeholders in the school setting, in the southern part of Sweden. Methods: A mixed-method design with three interconnected work packages (WP) will be undertaken with an emphasis on co-production where adolescents are involved throughout the process. WP1 is a development and validation of two questionnaire instruments for assessing social capital and help-seeking in adolescence. WP2 is a longitudinal quantitative study involving 1,500 adolescents from two regions representing rural and suburban/urban settings. Adolescents aged 15 will be asked to complete questionnaires concerning social capital, mental health, and help-seeking in a baseline and one-year follow-up, allowing for investigation of the role of social capital for help-seeking. WP3 is designed to elucidate experiences and knowledge of adolescents and key stakeholders via collaborative World Café workshops. These will be held along the project to evolve the generated knowledge and maximize it's applicability during and after the project is finalized. Conclusion: The results are expected to further the understanding of the relationship between adolescents' social capital, mental health, and help-seeking, to contribute to a deeper understanding of the mechanisms behind the paradoxical help-seeking patterns among adolescents today and to narrow the gap between research and practice to produce sustainable and efficient strategies, which may facilitate help-seeking and improve the mental health of adolescents within existing organizational structures. Copyright © 2024 Ahlborg, Morgan, Svedberg, Nygren, Eriksson and Westberg.

The social environment that adolescents interact in has undoubtedly changed over the past decades. The latent constructs of social capital that have been described in theory may be universal, but it is necessary to reveal sociocultural specific pathways and manifestation in order to validly operationalize social capital for adolescents. There is a call for qualitative data to enhance our understanding of social capital for adolescents today and the specific sociocultural context they live in. The aim of this study was to explore social capital from the perspective of adolescents in relation to mental health. Twenty-three semi-structured interviews were conducted in a school setting with a sample of adolescents aged 11 and 15 years. Qualitative content analysis was applied, and analysis remained on a manifest level. From having adolescents describe their social relations and networks in relation to mental health, three main categories were formed: accessing a safe space, with sub-categories of trusting enough to share, having someone close to you, and being part of an inclusive and honest environment; feeling connected to others, with sub-categories of hanging out and having things in common; and maintaining control, with sub-categories of deciding for yourself, dealing with change, and having social skills. Having access to a safe space is vital for adolescents’ mental health, by providing resources such as mutual trust, honesty, and unconditional access. Feeling connected to others is important in close relationships and reveals the glue that holds networks together, but also links to sociability in a wider sense. Predictability in adolescents’ social relationships and networks, influenced by internal and external factors, may be a resource of increasing importance in todays’ society and an interesting subject for intervention and future research on social capital and adolescent mental health. © 2023 by the authors.

There is a great heterogeneity in the conceptualization and operationalization of social capital in empirical research targeting adolescents. There has not yet been an attempt to systematically map and psychometrically evaluate the existing instruments for measuring social capital that have been developed and validated for adolescent samples. The aim of this systematic review was to identify and evaluate the design and psychometric properties of self-reported instruments for social capital, specifically developed and validated for use among adolescents. The design of this study was a systematic review guided by the COSMIN methodology for systematic reviews of Patient Reported Outcome Measures. The search included six electronic databases and no time frame was applied. Twenty studies were identified as describing the development and validation of a social capital instrument for adolescent samples. The results reveal common denominators, but also great variation in the design and validation of the instruments. Adolescents were only involved in the development procedures of four instruments. There is a lack of social capital instruments that cover both the multidimensionality of social capital and contextual relevance in relation to adolescents. Careful examination of instruments should thus precede a decision when designing studies and further instrument development involving the target group is encouraged. © 2022 by the authors.

The aim of this thesis was to explore social capital and inequalities in mental health among young adolescents in Sweden. This is a compilation thesis comprising four studies. Studies I and II are quantitative studies of crosssectional data from the Swedish Health Behaviour in School-aged Children survey. The aim of Study I was to investigate socioeconomic inequalities in health using both a subjective and an objective measure of socioeconomic status among Swedish adolescents. The findings showed that subjective socioeconomic status robustly and independently predicted mental health problems, poor life satisfaction and poor general health perception. The association between objective socioeconomic status and mental health was weakened, and even reversed, when subjective socioeconomic status was accounted for in regression models. A Latent Profile Analysis was applied in Study II with the aim of identifying distinct profiles of family, school and peer social capital in a nationally representative sample of adolescents and to explore health outcomes in those profiles. The findings showed that five distinct profiles best represented the data for 11 and 15-year olds, while a four-profile model was optimal for 13-year olds. Significant inequalities were identified between profiles when these were examined in terms of mental health problems and life satisfaction. The design of Study III was a qualitative semi-structured interview study. The aim was to explore social capital from the perspective of adolescents in relation to mental health. Adolescents spoke of having access to a safe space, feeling connected to others and predictability as important aspects of social relationships and networks in relation to mental health. The aim of Study IV was to identify and evaluate the design and psychometric properties of instruments for assessing social capital specifically developed and validated for self-reporting among adolescents (10-19 years). The design was a systematic review, in which 20 instruments were identified. The results revealed a lack of instruments that covered both the multidimensionality of social capital and contextual relevance in relation to adolescents. The conclusion from this thesis is that social capital may be useful for identifying vulnerable individuals and for differentiating between the natural imbalance of adolescence and what may lead to serious illness. Longitudinal research and refinement of the operationalization of the concept are, however, needed to enhance the understanding of these findings.