The Journey to Help 3: Sometimes Someone Else Opens the First Door
The phrase “seek assistance” makes us picture the person experiencing the problem doing the seeking. Sometimes that happens. Sometimes somebody else notices first. A parent sees changes developing over time. A friend becomes worried. A teacher notices someone withdrawing or repeatedly missing school. A health professional may discover something important while asking questions about an entirely different problem.
This matters particularly for young people. Research on adolescent substance-use treatment shows that adults often play important roles in connecting youth with care. The pathway can involve family, health professionals, schools and other people who help someone reach an appropriate service. Researchers sometimes describe people who facilitate that connection as gateway providers (1). You do not need to remember that term. The useful idea is much simpler: sometimes another person helps open the first door.
Family can be one of those doors, but “tell your family” is not automatically an easy instruction. Someone may fear disappointing people they love. They may worry about anger, punishment or what will happen next. Another young person might know exactly which family member will listen first and react later. Relationships differ. Advice that looks like one simple step from the outside can feel very different to the person taking it.
Health professionals create another route. Doctors, nurses, psychologists, counsellors and other professionals can listen, assess what is happening and help determine what kind of assistance is appropriate. Yet the young person still has to reach them somehow, and important information has to enter the conversation. Concerns about confidentiality and treatment-service characteristics appear in the adolescent help-seeking literature (1). Having professionals available is essential. It does not make the pathway automatic.
Friends occupy a different position. A friend may notice something or hear something nobody else knows. Caring does not require becoming a therapist, investigator or twenty-four-hour emergency department. Grade 7 students are not expected to diagnose substance use disorder. Sometimes being a good friend means recognizing that a situation has become too important to carry alone and involving an appropriate adult.
Now turn the question slightly toward yourself. If something genuinely difficult happened, who would you actually talk to? Not whom adults say you should talk to. Who would you really approach? You do not have to tell anyone your answer. Just notice whether a person came to mind quickly, whether you had to search for one, or whether approaching anyone felt uncomfortable.
That small thought experiment reveals something important. A list of helpful people and a relationship in which you can actually ask for help are not quite the same thing. Communities need services, but people also need pathways into them. Sometimes that pathway begins with a professional. Sometimes it begins at home or school. Sometimes it begins because one person notices another person and decides not to ignore what they are seeing.
References
For post 2 : James, P.D., Nash, M. and Comiskey, C.M. (2024), Barriers and Enablers for Adolescents Accessing Substance-Use Treatment: A Systematic Review and Narrative Synthesis. Int J Mental Health Nurs, 33: 1687-1710. https://doi.org/10.1111/inm.13378
Gov’t of Canada, PHAC site YSUPP: https://www.canada.ca/content/dam/hc-sc/documents/services/substance-use/canadian-drugs-substances-strategy/youth-substance-use-prevention-program/youth_substance_use_prevention_program.pdf?utm
Meisel SN, Pielech M, Magill M, Sawyer K, Miranda R Jr.Mechanisms of Behavior Change in Adolescent Substance Use Treatment: A Systematic Review of Treatment Mediators and Recommendations for Advancing Future Research. Clin Psychol (New York). 2024 Jun;31(2):154-173. doi: 10.1037/cps0000089. Epub 2022 May 12. PMID: 38883554; PMCID: PMC11178260. https://pubmed.ncbi.nlm.nih.gov/38883554/
Cole VT, Richmond-Rakerd LS, Bierce LF, Norotsky RL, Peiris ST, Hussong AM. Peer connectedness and substance use in adolescence: A systematic review and meta-analysis. Psychol Addict Behav. 2024 Feb;38(1):19-35. doi: 10.1037/adb0000914. Epub 2023 Mar 27. PMID: 36972090. https://pubmed.ncbi.nlm.nih.gov/36972090/
Rose ID, Lesesne CA, Sun J, Johns MM, Zhang X, Hertz M. The Relationship of School Connectedness to Adolescents' Engagement in Co-Occurring Health Risks: A Meta-Analytic Review. J Sch Nurs. 2024 Feb;40(1):58-73. doi: 10.1177/10598405221096802. Epub 2022 Apr 28. PMID: 35477342.) https://pubmed.ncbi.nlm.nih.gov/35477342/
Weatherson KA, O'Neill M, Lau EY, Qian W, Leatherdale ST, Faulkner GEJ. The Protective Effects of School Connectedness on Substance Use and Physical Activity. J Adolesc Health. 2018 Dec;63(6):724-731. doi: 10.1016/j.jadohealth.2018.07.002. Epub 2018 Sep 28. PMID: 30269908. https://pubmed.ncbi.nlm.nih.gov/30269908/
Chae J, Kim H. Effectiveness of School-Based Resilience Interventions on Adolescent Tobacco, Alcohol, and Illicit Substance Use: A Meta-Analysis. J Sch Health. 2026 Apr;96(4):e70137. doi: 10.1111/josh.70137. PMID: 41812678; PMCID: PMC12978879. https://pubmed.ncbi.nlm.nih.gov/41812678/
