Abstract
BACKGROUND: Understanding help-seeking behaviors of young people with mental health concerns is crucial for developing responsive mental health services and policies. This study aimed to explore the help-seeking journeys of Colombian youth, the formal and informal services they reached out to when faced with psychological distress and the order in which these services were consulted. Additionally, it examined the differences between pathways of actual service users and those modeled by fictional characters. METHODS: This study employed a mixed-methods design to explore help-seeking behaviors among Colombian youth (ages 10-19) facing mental health concerns, with a focus on service usage, sequence of access, and differences between actual (Clinical Sample, CLS) and perceived pathways (Community Sample, COS). The methodology combined semi-structured interviews, visual journey mapping, and social network analysis (SNA) to capture both qualitative and quantitative dimensions. RESULTS: 30 young people (53% female, median age = 16, IQR = 3) participated in interviews, of which 19 disclosed past service usage (CLS) and 11 narrated hypothetical scenarios (COS). The findings revealed the absence of a 'typical' care seeking pathway. A trend, however, was observed of prioritizing informal services, such as friends and family, as an initial step in help-seeking behavior. CLS participants reported longer and more complex service pathways, averaging 14.7 services, often involving specialists such as psychiatrists and other medical specializations, with third-party involvement (e.g., parents, educators) in initiating contact. Hypothetical journeys were shorter, with a median of 8 services, always initiated by the characters, and mostly resolved within community settings, with educators and psychologists as key sources of support. In both groups, the primary objective of help-seeking was symptom reduction; however, actual service users took two times longer (Mdn = 120, IQR = 700) to seek helpfrom the onset of symptoms than those projected on fictional characters (Mdn = 60 days, IQR = 90). CONCLUSIONS: The study demonstrates the importance of informal support systems regardless of youth's past service usage and help-seeking experience. It also reveals discrepancies between how help-seeking is perceived and experienced showing an underestimation of the complexity involved in finding mental health support which could potentially explain delays in help initiation and difficulties in navigating support resources.