The mental health service preferences of youth in Tasmania, Australia

Background: Youth mental illness is a global issue, with around three-quarters of all mental illnesses developing between the ages of 14 and 25. In Australia, access to mental health services is limited in rural and remote areas. Residents have to travel, sometimes long distances, to access mental healthcare. One strategy to mitigate the barrier of travel is the use of telehealth. However, it is unclear whether youth from rural and remote areas prefer to access telehealth mental health services or under what circumstances they would prefer to travel.

Methods: This study used a discrete choice experiment (DCE) to explore mental health service preferences amongst youth aged 13 to 25 years living in Tasmania. A DCE is a quantitative technique that presents a range of alternatives about a particular topic to participants. They then choose their preferred choice from various scenarios presented to them based on combinations of 'attributes' and their 'levels'. Participants were recruited through Facebook and completed the DCE through a self-completion questionnaire.

Findings: Of the valid responses (n= 214), greater importance was given to the attributes: the type of professional providing mental health services, cost and waiting time. A higher preference was recorded for in-person rather than online (telehealth) service delivery. Youth were more motivated to access services when they were 'very concerned' about their mental health status and when services were free, with no wait time and provided by a psychologist. Factors significantly associated with attribute preference included education level, employment status, mental health service awareness, rurality, socio-economic disadvantage and study status.

Conclusions: This study identified the preferences of youth for accessing mental health services and points to ways to improve mental health service provision in non-metropolitan areas. Further research is required to investigate whether rural and remote youth mental health care preferences change with mental health status, level of mental health literacy, or with a greater variety of service providers and service delivery methods.