Decision to access: Stigma related to mental health. CYP believing they would not be taken seriously or would not have a say in their treatment. CYP believing they could self-manage.

Reaching and entering services: Caregivers feeling hesitant to persist in asking for support for their child. Unfriendly reception staff. Delayed or rejected referrals to CAMHS or AMH.

Communication and trust: A lack of continuity of care and insufficient time in consultations. YP concerns about confidentiality. GPs lacking knowledge in how to manage CYP mental health.

Decision to access: CYP oral health was a lower priority for some caregivers than children’s physical health and developmental milestones. Caregivers feeling judged for their parenting or blamed for their child’s condition.

Reaching and entering services: Caregivers lacking practical resources and non-digital information.

Communication and trust: Caregivers feeling a sense of powerless and inferiority in the provider-patient interaction.

Reaching and entering services: Strict non-attendance and de-registration policies.

Communication and trust: A lack of continuity of care and insufficient time in consultations.

Decision to access: A lack of familiarity within the community of the syndrome/illness and stigma related to mental health. Perception of surveillance by healthcare systems. Experiences of stigma and discrimination. Lack of health information in other languages.

Reaching and entering services: Unfriendly reception staff. Lack of knowledge of the healthcare (and education) system.

Communication and trust: Repeated consultations resulting in little improvement or misdiagnosis. Lack of GP knowledge about the experiences and needs of ethnic minority groups. Health visiting teams lacking knowledge of culturally specific oral health guidance and feeding practices.

Decision to access: Caregivers feeling judged for their parenting or blamed for their child’s condition.

Reaching and entering services: Lack of knowledge of the healthcare (and education) system. Delayed or rejected referrals to secondary or adult care. Caregivers feeling hesitant to persist in asking for support for their child.

Communication and trust: Dentists lacking knowledge in caring for CYP with learning difficulties.

Reaching and entering services: Delayed or rejected referrals to secondary care. Caregivers feeling hesitant to persist in asking for support for their child.

Communication and trust: Repeated consultations resulting in little improvement or misdiagnosis. Lack of GP knowledge about some childhood chronic health problems.