Racial/Ethnic Disparities in the Decision Points of Mental Health Service Use and Psychotropic Medication Receipt Among Depressed Youth

Abstract

Depression has been increasing rapidly and is prevalent among youth. Inadequate mental health service utilization for youth and relevant racial/ethnic disparities are a growing concern. The current study used a nationally representative database to examine racial/ethnic disparities in youth depression prevalence, mental health services utilization, and psychotropic medication receipt. The sequential examination shows that depressed minority youth (22%-30%) were not only much less likely to use specialty mental health services than depressed Caucasian and multiracial youth (40%-43%, p < .001), they were also much less likely to receive psychotropic medications (22%-30%) than their Caucasian and multiracial counterparts (38%-44%, p = .048 to <.001) when using specialty mental health services. The findings reveal possibly two levels of racial/ethnic disparities at the decision points of accessing specialty mental health services and subsequent treatment methods choice. Implications for mental health policies and practices are also discussed.

Treatment Rates for Mental Disorders Among Children and Adolescents

“…The procedure of literature screening is shown in a PRISMA flowchart (Figure 1). In total, 39 251 records were found through literature searching, and 40 studies were included after being screened by the researchers. Refer to the eResults in Supplement 1 for the detailed retrieval steps.…”

“…Table 1 shows the characteristics of all studies . The 40 included articles were published between 1988 and 2021, and the data for the included studies were collected between 1984 and 2017 (5 studies did not specify when the data were collected).…”

The Impact of a Universal Mental Health Intervention on Youth with Elevated Negative Affectivity: Building Resilience for Healthy Kids

“…Rates of death by suicide among youth aged 10–24 years increased by 56% from 2007 to 2017 (Curtin, 2020 ; Curtin & Hedegaard, 2019 ; Lee & Wong, 2020 ; Oh et al, 2019 ). In parallel to the increasing prevalence of youth suicide, there has been a rapid increase in youth diagnosed with depression (Zhang et al, 2019 ). The onset of depressive disorders typically occurs in early-to-middle adolescence (ages 11–15 years) and, if untreated, tracks into adulthood (Feiss et al, 2019 ; Fergus & Zimmerman, 2005 ; Luthar et al, 2000 ; Mongelli et al, 2020 ).…”

“…The onset of depressive disorders typically occurs in early-to-middle adolescence (ages 11–15 years) and, if untreated, tracks into adulthood (Feiss et al, 2019 ; Fergus & Zimmerman, 2005 ; Luthar et al, 2000 ; Mongelli et al, 2020 ). Elevated anxiety symptoms during the early adolescent period (11–12 years) are a predictor of later depression and suicide among youth (Lee et al, 2020 ; Zhang et al, 2019 ). Therefore, efforts to decrease anxiety and depression symptoms, collectively referred to as “negative affectivity,” in early adolescent youth are integral for early suicide prevention efforts.…”

“…later depression and suicide among youth (Lee et al, 2020;Zhang et al, 2019). Therefore, efforts to decrease anxiety and depression symptoms, collectively referred to as "negative affectivity," in early adolescent youth are integral for early suicide prevention efforts.…”