Objective
Adolescents in high socioeconomic status (SES) contexts have emerged as an at-risk subgroup for certain mental health concerns, including substance use. However, there is limited international evidence examining whether and how these adolescents seek help. This study aimed to explore the factors influencing adolescents' decisions to engage in, or avoid, help-seeking for mental health concerns in high SES contexts.


Method
Semi-structured interviews were conducted with ten adolescents aged 15-19 years attending independent or government schools in high SES contexts. Participants shared their lived experiences and perspectives on help-seeking for mental health concerns. Data were analysed using Interpretative Phenomenological Analysis (IPA) as outlined by Jonathan Smith.


Results
Two overarching themes were identified: Complex Power and Authority and Sociocultural Influences on Perceived Social Norms. Findings revealed that perceived and experienced breaches of confidentiality were a central and influential factor shaping adolescents' reluctance to seek help. Participants described concerns related to ethical frameworks and policy, particularly confidentiality and mandatory reporting, as well as power imbalances, dual relationships, and fears of loss of control. These experiences were compounded by strong sociocultural expectations to maintain privacy, reputation, and self-reliance, contributing to secrecy and delayed help-seeking.


Discussion
This presentation will concentrate on adolescents' accounts of confidentiality breaches and the ways these experiences undermine trust in school-based systems. The implications for future practice will be discussed, with particular attention to ethical decision-making, school policy, and the management of dual relationships. Opportunities for system-level change and early intervention will be highlighted to strengthen duty of care, promote ethical practice, and support help-seeking across adolescence and emerging adulthood.