Abstract

Background
Common mental disorders (CMDs) and psychological distress contribute substantially to morbidity among adolescents in India yet help-seeking remains limited. Understanding determinants of help-seeking behaviour is essential to designing context-specific, adolescent-friendly mental health interventions.

Methods
This systematic review was conducted following MOOSE guidelines and reported in line with PRISMA 2020 framework. Searches across PubMed, EMBASE, PsycINFO, and CINAHL identified studies published between January 2010 and April 2025. Eligible studies included qualitative, quantitative, and mixed-methods research conducted among adolescents aged 10–19 years in India that examined barriers or facilitators to help-seeking for CMDs, psychological distress, self-harm, or substance misuse. Data were synthesised narratively using an integrative thematic approach.

Results
Twenty-six studies (reported in 27 articles) met inclusion criteria. Most were school-based; only a small number of studies were conducted exclusively in urban slum settings. Across study types, stigma (self, public and structural) emerged as the most pervasive barrier to seeking care. Low mental health literacy among adolescents, parents, and teachers further delayed help-seeking. Additional barriers included negative or distrustful experiences with healthcare providers, concerns regarding confidentiality, academic pressures, and socioeconomic constraints. Facilitators included supportive peers and families, positive relationships with counsellors, psychoeducation delivered through school- or community-based programmes, and involvement of trained lay counsellors. Technology-enabled approaches showed promise but faced acceptability challenges within families.

Conclusion
Help-seeking among adolescents in India is shaped by multilayered individual, social, and structural barriers, with stigma and low mental health literacy at the core. Youth-centred interventions that promote literacy, reduce stigma, strengthen social support networks, and increase acceptability of services are crucial. Evidence gaps are substantial for adolescents in vulnerable contexts, particularly those living in urban slums.