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Based on adolescent experiences, key risk factors for their mental health should be detected to inform preventive interventions. Focus group sessions were conducted in Cyprus, Germany, Italy, Poland, Slovenia, Spain, and the UK with adolescents aged 10 to 24 years, and their stakeholders (parents, school professionals and clinicians). The discussions followed a broad rationale asking about stressors, coping strategies, and barriers and facilitators of help-seeking. The recorded sessions were transcribed and analysed via thematic analysis. All seven sites conducted the analysis in local languages and final results were collated after translation. Overall, 124 adolescents and 81 stakeholders participated in 40 focus groups. Across all age groups of adolescents, pressure to perform academically and social life were core influencers of mental health. Trust was the key prerequisite for seeking support, whereby personal contacts were the foremost points of contact. Both groups recognized advantages and limitations of digital resources, although adolescents were more likely to mention positive aspects. Adolescents and stakeholders both viewed lack of trust and fear of judgment as significant barriers against accessing support services. Risk factors for the mental health of adolescents encompassed both personal and sociocultural aspects. Our findings highlight the need for mental health literacy of adolescents and their stakehoders to overcome personal risk factors. Sociocultural prevention must focus on building secure, non-judgmental relationships within school environments and professional support systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00787-026-03216-y","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:22:06Z","timestamp":1792023726000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding mental health and help-seeking among adolescents in Europe: a focus group-based participatory study to inform preventive 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Sites are linked through a common protocol and measures and a cross sites data sharing agreement which allows for combined analysis of findings. Specifically, the trial was approved by the Institute of Psychology at SWPS University in Warsaw, Poland (Opinion No. 01\/2023), the Research Ethics Committee at the Faculty of Arts, University of Maribor (038-22-157\/2023\/44\/FF\/UM) in Maribor, Slovenia, University of Edinburgh School of Health in Social Science Research Ethics Committee (23-24CLPS050) in Edinburgh, United Kingdom, Heriot-Watt University Social Sciences Ethics Committee (2023-5589-8713) in Edinburgh, United Kingdom, Cyprus National Bioethics Committee (102283) in Nicosia, Cyprus, Ethics committee of the INTRAS Foundation in Valladolid, Spain, Ethics Committee of the Medical Faculty of Heidelberg University (S-484\/2023) in Heidelberg, Germany, and Bioethics Committee of the University of Bologna (0033400) in Bologna, Italy.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"For participants who are minors, both the participant\u2019s informed assent and the legal guardian\u2019s informed consent were required. Only minors for whom both forms of agreement were obtained were eligible to participate in the study. The age threshold requiring legal guardian consent varies across participating countries, and the study procedures were implemented in full compliance with the respective national regulations. Specifically, in Poland, Spain, Germany, Cyprus, and Italy parental or legal guardian consent was obtained for participants under the age of 18, whereas in Slovenia such consent was required for participants under the age of 15, and in the UK for those under the age of 16. Participants in Germany received small book vouchers valued at 25\u20ac, participants in Cyprus received a 10\u20ac voucher and adolescent participants in Poland received small gifts. Participation in the study was entirely voluntary. All participants were informed, in age-appropriate language, that they may withdraw from the study at any time without providing a reason and without any consequences.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"During the preparation of this manuscript, the authors used ChatGPT and DeepL in order to translate codes and quotes from the original language to English. To meet the highest data protection standards only anonymized data was translated and no personal data was involved. After using these services, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.","order":3,"name":"Ethics","label":"Use of AI-assisted technologies","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}