Racial and Ethnic Disparities in Adolescent Utilization of School Based Mental Health Services

Background: Adolescent mental health is a major public health concern in the United States and schools are an ideal location to offer mental health services. Objective: An examination of combined racial/ethnic disparities pertaining to socio-demographic and contextual factors associated with adolescent utilization of school based mental health services (SBMHS) was conducted to optimize the use and potential benefits of these services. Method: Data from the 2019 National Survey on Drug Use and Health was used to estimate multilevel and multivariable logistic regression models. Indicators included socio-demographics, depression, religiosity, parental monitoring and support, and school and academic engagement. Results: Asian adolescents were less likely to utilize SBMHS compared to their White counterparts (OR = 0.62; 95% CI = 0.41, 0.95). All five racial/ethnic groups reported a statistically higher likelihood of utilizing SBMHS as depressive symptoms increased (OR = 1.15–1.28). Black adolescents were the only racial/ethnic group who reported lower odds (OR = 0.93; 95% CI = 0.88, 0.98) of utilizing SBMHS as their religiosity increased. Parental monitoring and support was not associated with SBMHS use for any group. White, Black, and Asian adolescents reported greater odds of utilizing SBMHS as their school and academic engagement increased (OR = 1.12; 95% CI = 1.05, 1.19; OR = 1.15; 95% CI = 1.01, 1.31; OR = 1.43; 95% CI = 1.04, 1.95, respectively). Conclusion: Findings enhance understanding of the racial/ethnic disparities involved with adolescent utilization of SBMHS and may help identify those in need, tailor interventions, and optimize use of evidence-based treatments.