Mental Health-Related Disabilities, Healthcare Utilization, and Access in Young Adults with Anxiety and Depression: A Scoping Review

Abstract

Young adults with anxiety and depression often experience mental health-related disabilities (MHRD) that impair social, academic, occupational and daily functioning. These impairments, while significant, are frequently invisible, episodic, or lacking formal recognition; factors that limit their acknowledgment within healthcare systems designed to respond to more visible or diagnostically stable conditions. As MHRD rates among young adults rise there remains limited evidence on how functional impairments shape access to care. This scoping review examines peer-reviewed research on healthcare access and utilization for young adults aged 18 to 30 with anxiety and/or depression, with particular attention to how disability and functional impairment are defined, measured, and operationalized. The review was guided by the JBI (formerly Joanna Briggs Institute) methodology for scoping reviews and reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The finalized search strategy was applied across four major databases: MEDLINE, CINAHL, PsycINFO, and Embase, covering all available years from 2013 to February 27, 2025. Studies were eligible if they examined access or utilization of healthcare services for young adults with anxiety and/or depression and addressed disability or functional impairment either directly or through related constructs. Only peer-reviewed articles published in English were included. A total of 20 studies met the inclusion criteria and were analyzed using descriptive and pre-defined classifications. Findings reveal that while access barriers are consistently reported, disability and functional impairment are rarely examined through frameworks that center disability as a primary analytic focus. Instead of drawing on established tools or models designed to assess impairment and functioning, many studies relied on diagnostic categories or symptom scales as indirect proxies. This limited the conceptual clarity and comparability of findings across studies. The invisibility of MHRD was rarely named, but evident in how inconsistently impairments were defined, measured, or accommodated. Across studies, impairments were most commonly reported in relation to interpersonal functioning, learning, cognition, and emotional regulation. Despite the diversity of health system contexts represented, including universal and insurance-based models, access inequities persisted across settings. Notably, few studies engaged youth or young adults with lived experience in the research process, and very few applied social theories or disability frameworks to guide their analysis.This review highlights a disconnect between how MHRD is experienced and how it is represented in the research evidence. While there is growing awareness of these limitations, few studies have moved beyond identification of gaps. Advancing access for this population will require greater theoretical clarity, participatory approaches, and the deliberate inclusion of MHRD as a core analytic category in health research.