A national study of race/ethnic disparities and immigrant status in youth mental health service in the United States

Introduction: Access to mental health care can be problematic for all youth, and minority adolescents may be at particular risk of not receiving services. Further, the growing immigrant population is comprised largely of racial and ethnic minority children and youth, many of whom are significantly less likely to have health insurance coverage. The present study uses a nationally representative sample to examine whether differences found for high-need racial/ethnic minority youth persist in the national population. The role of immigrant status on mental health service use is also examined. Methods: Data are derived from the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative, school-based sample of 20,743 adolescents, with sufficient racial and ethnic diversity to draw meaningful conclusions across minority groups. Logistic regression and post-estimation analyses were conducted to examine service use. Results: About 12% of youth (N=2556) sought any mental health services. Compared to non-Hispanic Whites, African-American and Hispanic youth were significantly less likely to use any mental health services (AA:OR=.55,p<.001; H:OR=.68,p<.001). However, for Hispanic youth, parental immigrant status, rather than ethnicity, played a larger role in whether youth received services (OR=.58,p<.001). Findings held independent of emotional and behavioral problems, socioeconomic position, and insurance status. Conclusion: This project is among the first examining mental health service use for youth in the national population. The findings speak directly to health policy issues regarding race/ethnicity, immigrant status, and insurance status. Further research should examine the role of minority youth social networks in accessing mental health services.