Barriers and disparities in adolescent mental health service access in the UK: A systematic review

Objective Adolescent mental health in the UK is an urgent public health concern, with rising prevalence and persistent inequities in access to care. This systematic review synthesises qualitative evidence on barriers and disparities affecting adolescents in engaging with mental health services across the UK, and interprets findings using the Social-Ecological Model (SEM). Methods The review followed PRISMA 2020 guidance and was registered in PROSPERO (CRD42025652782). Peer-reviewed qualitative studies (UK; ages 10 – 19) published between 2014 and 2024 were searched across multiple databases using predefined terms and eligibility criteria. Two reviewers undertook screening with discrepancy resolution procedures, studies were critically appraised, and findings were thematically synthesised. Results Eight qualitative studies (published 2014 – 2024) were included, comprising 97 adolescent participants across UK settings. Five key barriers were identified: (1) limited mental health literacy, (2) stigma and fear of judgement, (3) lack of culturally competent care, (4) economic deprivation and long waiting times, and (5) gendered norms surrounding help-seeking. Three intersecting disparities (ethnic and cultural, socio-economic, and geographic) further constrained access. Interpreted through the SEM, barriers operated across individual, interpersonal, community/school, and system levels. Conclusion This UK-specific synthesis highlights multi-level barriers and intersecting disparities that delay or prevent adolescents’ access to mental health support. With over 109,000 young people reportedly on mental health waiting lists in England alone, findings underscore the need for targeted reforms to improve timely, inclusive access, strengthening mental health literacy, embedding culturally adapted care, improving geographic accessibility, and integrating support within educational settings.