Health and basic demographic characteristics were collected from the case registers of the four service providers in the area. Data was collected over an eight-week period. All transcripts were imported into MAXQDA 12 for data cleaning and coding. The target population for this study included mental health service providers, identified key stakeholders, caregivers of mentally ill adolescents as well as adolescent patients between 10 and 19 years of age.

Health service providers were purposively sampled to partake in a semi-structured interview. This included one Clinical Psychologist, two Community Psychiatric Officers (CPO), one Community Psychiatric Nurse and two Community Mental Health Officers. Other targeted study participants included stakeholders in the implementation of services, such as a Mental Health Authority (MHA) representative, and National Health Insurance Scheme (NHIS) Managers. Also recruited for the study were stakeholders who have professional interactions with adolescents such as School Counsellors, School Health Education Programme (SHEP) Coordinators and the department of Social Welfare.

Participants were contacted directly through mobile phone or visits and gave written consent before participating in the interviews. Interviews were conducted in English and then transcribed. All interviews were digitally recorded in person with two recording devices and lasted 30–60 min.

All participant forms were collected by the study team and kept in the study file in a secure location. All electronic files with identifying information were also kept in a secure, password protected location.

Primary caregivers were recruited purposively from members of an association of caregivers at the Psychosocial Centre. To ensure respondents would give accurate and unbiased responses, the Focus Group Discussion (FGD) took place on the premises of the Kintampo Health Research Centre (KHRC) without the Psychosocial Centre staff. The FGD lasted exactly one hour and was conducted in Twi in early October 2016. After participants signed and gave consent to be interviewed, the discussion which lasted 30–60 min was digitally recorded.

Adolescent users identified for this study (Table (Table1,1, Appendix D) have had to at least complete one visit with one of the identified providers and have at least one diagnosis of a mental or neurological disorder either in the past or at present. Adolescent respondents also had to be verbally communicative, in a state lucid and healthy enough to participate (as identified by service providers), and willing to give signed consent along with parental or guardian consent. All parents or guardians were given verbal explanation and interpretation (in Twi) of the written consent form, the study purpose and the reason for interview request. Consent forms were then signed by the parent or guardian, or a thumb print was accepted as a signature on behalf of the child.

Demographic Characteristics of the study participants

NHIS National Health Insurance Scheme

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