‘Multi-stressed’: A qualitative study exploring the impact of the social determinants of health on access to digital mental health for youth and young adults in Alberta
Bibliographic record
Abstract
Background: Mental illness among youth (ages 15-24) is a critical and global public health issue. Youth's pathways to accessing mental healthcare are complex, non-linear, and mediated by the social determinants of health - including social, economic, environmental, and systemic factors. Digital mental health is recognised as a potential solution to address inequitable access to mental healthcare among youth. However, concerns have been raised regarding access to digital mental health for youth who are underserved and excluded by current mental healthcare systems. Access to digital mental health is a matter of mental health equity requiring urgent attention. Methods: This study explores mental healthcare providers' perspectives of how the social determinants of health affect access to digital mental health for youth in Alberta, Canada. A qualitative descriptive methodology was utilised to analyse focus group data and identify pertinent themes. Results: Twenty-three focus groups were conducted with 168 participants from schools, specialised mental health services, primary care networks, and community-based mental health service settings. Findings show that youth's access to digital mental health is impacted by three overarching and intersecting themes: (1) social influences, (2) socio-economic circumstances, and (3) community contextual and systemic factors. Conclusions: The three themes indicate that the social determinants of health do not occur in isolation and may combine to produce multiple forms of disadvantage. Practical considerations and recommendations emphasise the need to address the social determinants of health to ensure that all youth benefit equitably from emerging digital solutions.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".