Structural Correlates of Mental Health Support Access Among Sexual Minority Youth of Color During COVID-19

Abstract

Objective: Many youth with mental health needs cannot access treatment, with multiply-marginalized youth, such as sexual minority youth of Color (SMYoC), experiencing both structural and identity-related barriers to care. The COVID-19 pandemic threatens to exacerbate multi-level treatment access barriers facing SMYoC youth nationwide. However, little large-scale research has examined access to mental health care among SMYoC across the United States, either during or prior to the pandemic. Such work is critical to understanding and ameliorating barriers in this domain. Methods: Using data from adolescents who self-identified as SMYoC and who endorsed a desire for mental health support during the COVID-19 pandemic (N=470, ages 13-16, from 43 U.S. states), we examined associations between state-level, structural factors (income inequality; mental healthcare provider shortage; anti-Black racism; homophobia; and the interaction between anti-Black racism and homophobia) and SMYoC mental health treatment access. Results: Multinomial logistic regressions revealed state-level mental healthcare provider shortage as the only significant predictor of SMYoC reporting they never (versus always) accessed mental health support during the COVID-19 pandemic. SMYoC living in areas with both lower homophobia and lower anti-Black racism were more likely to report always (versus sometimes) accessing mental health treatment. Conclusions: Results highlight the critical importance of considering diverse structural factors and applying an intersectional lens when exploring barriers to mental health treatment among multiply-marginalized youth. In locations where provider shortages are less severe, cultural stigma—including anti-Black racism and homophobia—may still pose challenges for SMYoC in need of mental health care.

Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of postacute sequelae of SARS‐CoV‐2 infection (PASC) in children and adolescents

“…Many children have undergone the trauma of losing a loved one to COVID‐19 and may experience symptoms of grief, exacerbating psychological and physical symptoms of PASC. Additionally, the pandemic has exacerbated difficulty with access to mental health care for many populations such as racial and ethnic minority groups and gender/sexual minority individuals 56 . One study demonstrated that children, girls, those with Hispanic ethnicity, those with public versus private insurance, and those with more significant medical comorbidity were more likely to exhibit PASC neuropsychiatric symptoms, 57 although these demographic and socioeconomic factors need to be studied further.…”

“…Additionally, the pandemic has exacerbated difficulty with access to mental health care for many populations such as racial and ethnic minority groups and gender/sexual minority individuals. 56 One study demonstrated that children, girls, those with Hispanic ethnicity, those with public versus private insurance, and those with more significant medical comorbidity were more likely to exhibit PASC neuropsychiatric symptoms, 57 although these demographic and socioeconomic factors need to be studied further. With the increase in mental health problems since the start of the pandemic it is particularly important to screen for mental health symptoms in all youth with PASC, and in particular, screen for suicidal ideation especially if there are known past attempts, past suicidal ideation, or changes in mood.…”

Future Directions in Mental Health Treatment with Stigmatized Youth

“…A. Price, Weisz, et al, 2022) and access (Hollinsaid et al, 2022;Roulston et al, 2022) for stigmatized youth (see Figure 1). The present paper provides a brief overview of the scientific literature on structural stigma and youth mental health treatment, and details three future research directions we hope readers pursue.…”

Future Directions in Mental Health Treatment with Stigmatized Youth

“…A. Price, Weisz, et al, 2022) and access (Hollinsaid et al, 2022;Roulston et al, 2022) for stigmatized youth (see Figure 1). The present paper provides a brief overview of the scientific literature on structural stigma and youth mental health treatment, and details three future research directions we hope readers pursue.…”