# “We Are Humans, and We Are People” - A Thematic Analysis Exploring the Disclosure and Help-Seeking Experiences of Young People Who Experience Voice-Hearing Within Mental Health Services in the UK

## TL;DR

This study explores how young people in the UK disclose and seek help for hearing voices within mental health services, finding that trust and personalized care are crucial for engagement.

## Contribution

The study provides new insights into the barriers and facilitators of help-seeking for voice-hearing among UK youth within mental health services.

## Key findings

- Stigma, long waiting lists, and lack of practitioner knowledge act as barriers to disclosure and help-seeking.
- Trust and clear communication facilitate engagement and disclosure among young voice-hearers.
- Flexible, person-centered support and empathetic practitioners improve young people's experiences and confidence.

## Abstract

Voice-hearing is increasingly being recognised as a transdiagnostic experience which is common for children and adolescents. However, little is known about how young people seek help and disclose voice-hearing within mental health services.

This qualitative study explored the disclosure and help-seeking experiences of nine young people (aged 14–18) receiving care from mental health services in the UK. Semi-structured interviews were conducted and analysed using thematic analysis within a critical realist framework.

Two superordinate themes were identified: barriers to accessing help; facilitators to accessing help; and the impact of practitioner response on young people’s engagement. Stigma, long waiting lists for services, and practitioners’ lack of knowledge often acted as barriers to disclosure and help-seeking, whereas trust and clear communication facilitated disclosure and engagement. Participants often wished to be listened to, to be offered a more personalised approach and greater flexibility from mental health services. When practitioners demonstrated empathy and allowed trust to build in the therapeutic relationship, participants felt valued.

Findings suggest that practitioners might need to be supported to build confidence in discussing voice-hearing with young people to facilitate therapeutic conversations about these experiences, and that offering flexible, person-centred support may support young people’s engagement with mental health services.

What was this research about? Some young people hear voices that others don’t, and for many, this can be distressing. Although fairly common in children and teenagers, little is known about how young people talk about hearing voices or seek support, especially within mental health services. Understanding their experiences can help improve how services respond. What did the researchers do? A researcher interviewed nine young people aged 14 to 18 who were receiving care from UK mental health services and had experience of hearing distressing voices. They were asked about who they shared this with and what helped or made it harder to get support. The research team analysed their stories to identify common themes. What did the researchers find? Young people often delayed talking about hearing voices because they were worried about being judged or misunderstood. Some avoided services or found it hard to trust professionals. Barriers included long waiting times, being passed between services, and professionals not knowing much about voice-hearing. Participants felt frustrated when their experiences were dismissed or avoided. On the other hand, young people felt more comfortable opening up when practitioners built trust, listened without judgement, and explained available support. Flexible, personalised care was valued over rigid, one-size-fits-all approaches. Feeling accepted and understood helped young people feel more confident in managing their experiences. Why is this important? The findings suggest mental health services could better support young people who hear voices by offering flexible care, building trust, and ensuring practitioners are trained and informed. These changes could help reduce stigma and encourage more young people to seek help and get the support they need.