How Do Young People Accessing Mental Health Services Describe and Understand Emotional Distress?

Background and aim: There has been growing acknowledgement of the role of emotional distress in the development of mental health difficulties yet despite adolescence being a complex developmental stage, where individuals develop an increasingly sophisticated conceptual framework for their emotional experiences, research has focused on normative adult populations. Furthermore, a lack of shared concept and pragmatic research considerations has led to a diverse conceptualisation of emotional distress and the use of quantitative methodology. Very little qualitative research has been conducted examining the subjective experiences of young people experiencing mental health difficulties so the aim of this study was to explore how young people accessing mental health services talk about and understand their experience of emotional distress.

Method: Eight interviews were conducted with young people aged between 14 and 17 years old who were accessing a Tier 4 Child and Adolescent Mental Health Service (CAMHS). The interview transcripts were analysed using thematic analysis.

Results: Four themes were produced in the analysis and were 1) Experience of emotional distress: Emotions are uncontrollable, 2) Impact of emotional expression: Isolations, 3) Management of emotional distress: Self regulation and 4) Reaction to emotional distress: Service provision. They highlight the young people’s understanding of emotional distress and the associated consequences including response by professionals, difficulties with interpersonal relationships and the use of coping mechanisms.

Discussion: The young people described and understood their experiences of emotional distress to have had significant and ongoing impact on their lives. These findings provide support for existing literature but also make new contributions to the evidence base by representing the voice of a marginalised and difficult to access service user group. The theoretical implications of the results consider the importance of continued qualitative investigation in how young people understand and experience emotional distress. Clinical implications were discussed in terms of the commonalities in the conceptualisation of distress between young people and clinical practice. Future directions for research were also discussed.