Adolescents and young adults often suffer from depression, but tend to avoid seeking professional help. The aim of this study was to explore the reasons for non-professional-help-seeking in a sample of young adults resident in Catalonia with depressive symptoms through a qualitative study. In addition, the subjects were invited to offer their recommendations for making mental health care services more accessible. We recruited 105 young persons (17–21 years of age) who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants were interviewed in depth about their reasons for avoiding professional mental health care services, and the interview results were analyzed using both qualitative and cultural domain techniques and corroborated through comparison with the results of three focus groups. Participants’ reasons for avoidance varied both by gender and according to prior experience with health services. Male study participants and female controls mainly understood depressive symptoms as normal and therefore not requiring treatment. Female participants with self-perceived distress were more likely to cite problems of access to treatment and fear of speaking to an unknown person about their problems. Females with a diagnosis expressed lack of trust in the benefits of treatment and fear of the social consequences of help-seeking. In their recommendations for best practices, the study participants suggested educational initiatives, as well as changes in the organization of mental health care services. A better understanding of the views of young people and a greater effort to involve them as active participants is important for facilitating help-seeking in this age group, and for adapting mental health care services to adolescent users and their social context.

Depression affects a considerable proportion (12–25 %) of adolescents and so-called emerging adults (ages of 18 and 25). The aims of this study were to explore the relationship between perceived social support and depression in a sample of emerging adults, and subsequently to identify the type of social support young people consider most helpful in dealing with this type of emotional distress. A sample of 105 young persons (17–21 years of age) was selected from a previous longitudinal study to create three groups of participants: subjects with a previous diagnosis of depression; subjects with self-perceived but undiagnosed distress compatible with depression; and a group of controls. Qualitative and validated instruments for measuring depressive symptoms (the BDI-II, Beck depression inventory) and social support (the Mannheim interview on social support) were administered. Loss of friendships over time and dissatisfaction with social and psychological support are variables associated with depression in emerging adulthood. Qualitative analysis revealed gender differences both in strategies for managing distress, and in how social support was understood to mitigate depressive symptoms. Male study participants prioritized support that helped them achieve self-control as a first step toward awareness of their emotional distress, while female study participants prioritized support that helped them achieve awareness of the problem as a first step toward self-control. Treatment for emerging adults with depression should take into account not only the impact of social support, but also gender differences in what they consider to be the most appropriate form of social support for dealing with emotional distress.

La salud colectiva es ya un paradigma de largo recorrido en América Latina. La salud mental colectiva, por su parte, ha tenido un desarrollo relevante en algunos países latinoamericanos, e incluso ha actuado como estímulo para la reforma psiquiátrica en estos países. Sin embargo, ambas aparecen encapsuladas en un tiempo y territorio, entre otras cosas, por la hegemonía de una epistemología-mundo que, mientras ha impuesto un modelo naturalizado de verdad, ha negado la posibilidad de que otros saberes discutan sobre aquello ya ordenado (nosologías, protocolos, políticas, etc.), y menos aún sobre el propio ordenamiento. En este artículo reflexionamos sobre el poder de la etnografía, en tanto forma de conocimiento y relación social en sí misma, para ensanchar los espacios para una salud colectiva posible en un contexto donde aún es incipiente: Europa. La idea es que el punto de vista etnográfico facilita repensar lo ya dado, creando permeabilidad en las prácticas ya sedimentadas, así como nuevas ventanas de asombro.

Nos últimos anos, o método etnográfico revelou-se como um adequado instrumento para as intervenções em saúde pública e na educação em saúde. Não obstante, seu uso contradiz determinados modelos de intervenção definidos como monológicos, a exemplo das campanhas de meios de comunicação de massa e as filosofias do "ator racional". Foram analisadas criticamente algumas bases epistemológicas desses modelos, como a unidimensionalidade na análise dos processos de saúde/doença/atendimento, a unidirecionalidade comunicativa e a hierarquia. No seu lugar, propõe-se um modelo dialógico baseado no método etnográfico e organizado a partir dos critérios de multidimensionalidade, bidirecionalidade e simetria. A etnografia permite melhorar a efetividade das intervenções ao fornecer uma base empírica para o desenho dos projetos e ao propiciar a participação social em saúde.

Emotional distress is common in adolescence, and self-care strategies are frequently preferred to address it. The aim of this article is to analyze the self-care strategies among adolescents and young people diagnosed with depression or with self-perceived depressive distress in Catalonia using a qualitative design. We analyzed the self-care strategies of 105 young people (17–21 years of age) in Catalonia who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants’ narratives on self-care strategies for emotional distress were elicited through in-depth semi-structured interviews. The data were managed using ATLAS-Ti 6.5 software18. We applied hermeneutic theory and the ethnographic method to analyze the interviews. The ten self-care strategies identified in the analysis were grouped into four areas covering the various pathways the young people followed according to whether they had a diagnosis of depression or their depressive distress was self-perceived. The young people feel responsible for their emotional distress and consider that they are capable of resolving it through their own resources. Their strategies ranged from their individuality to sociability expressed through their relationships with others, membership of groups or other self-care strategies (relaxation, meditation, naturopathy, etc.). The study results highlight the importance of sensitivity in considering young people’s self-care strategies as another option in the care of emotional distress.