Mental Health Concerns and Help-Seeking Behaviors Among Adolescents in High Socioeconomic Status Groups: A Scoping Review

There is growing evidence that adolescents in high socioeconomic status groups may be at increased risk for some mental health concerns. This scoping review aims to synthesize empirical literature from 2010 to 2021 on mental health concerns and help-seeking behaviors among this adolescent group. Six comprehensive electronic databases yielded 1316 studies that were systematically reviewed in Covidence to identify relevant research. PRISMA-ScR analysis was used. Eighty-three studies met the eligibility requirements. NVivo was employed for coding, data extraction, and analysis. Key findings suggest substance use, in particular, alcohol, is the main mental health concern among adolescents in high socioeconomic status groups. Other main mental health concerns were externalizing and risk behaviors, bullying, depression, anxiety and stress. These concerns were shown to be influenced by parents, peers, school, and neighborhood contextual factors. Three emerging subgroups were identified as being at higher risk of mental health concerns among adolescents in high socioeconomic status groups. Specifically, adolescents residing in boarding schools, those with high subjective social status (e.g., popular) or low academic performance. Being pressured by parents to perform well academically was identified as a risk-factor for substance use, depression and anxiety. Albeit limited, areas explored for help-seeking behaviors centered on formal, semi-formal and informal support. Further research examining multi-level socioeconomic status factors and mental health concerns and help-seeking behaviors are urgently needed to inform appropriate interventions for this under-represented group.