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The meanings young people assign to living with mental illness and their experiences in managing their health and lives: a systematic review of qualitative evidence.

BACKGROUND: It is estimated that less than 25% of young people in need of treatment for mental illness receive specialized services, and even fewer receive a diagnosis by their doctor. These findings are troubling given that living with a mental illness can have a significant impact on a young person's life, the lives of his/her family members, the young person's community and society generally.

OBJECTIVE: The objective of this systematic review was to synthesize the best available qualitative evidence on the meanings young people assign to living with mental illness and their experiences in managing their health and lives.

INCLUSION CRITERIA: The current review considered both interpretive and critical research studies that drew on the experiences of young people with mental illness.

SEARCH STRATEGY: The search for published studies included the following databases: MEDLINE, CINAHL, Social Sciences Full Text, PsycINFO, Social Work Abstracts, Sociological Abstracts, Embase, Social Services Abstracts, Child Development and Adolescent Studies, Scopus, Web of Science and Academic Search Complete. The search for unpublished studies included conference proceedings and ProQuest Dissertations and Theses Database.

METHODOLOGICAL QUALITY: Each paper was assessed independently by two reviewers for methodological quality. The Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) was used to appraise the methodological quality of the articles.

DATA EXTRACTION: Qualitative data were extracted from papers included in the review using the standardized data extraction tool from JBI-QARI.

DATA SYNTHESIS: JBI-QARI was used to pool findings based on their similarity of meaning and developed into four synthesized findings.

RESULTS: Fifty-four research papers generated 304 study findings that were aggregated into nine categories. The nine categories were further aggregated into four synthesis statements: (1) A different way of being, (2) Getting through the difficult times, (3) Yearning for acceptance and (4) Room for improvement.

CONCLUSION: Young people with mental illness experienced a range of feelings and thoughts that at times left them feeling uncomfortable in their body and world. Rejection by family and friends was a common fear. The changes experienced by young people required them to use a variety of strategies that were both negative and positive. The challenges young people faced in seeking and receiving care reinforce that there is a need for improvement in mental health services for youth living with mental illness.

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