TOPLINE:

Less than half of US adolescents with major depressive episode (MDE) received treatment for the condition, with Black, male, and rural participants having significantly lower odds of receiving specialist care than their peers, a new study showed. Additionally, insurance coverage strongly affected access to telehealth services.

METHODOLOGY:

• Researchers analyzed data from the 2022 National Survey on Drug Use and Health, which was conducted in all 50 US states and the District of Columbia.
• The analysis included more than 2000 adolescents aged 12-17 years (71% girls, 54% White and 12% Black individuals, 58% from large urban areas) who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for MDE in the past year.
• Main outcomes included the use of various types of mental health services, such as treatment by a specialist clinician, prescription medication, and telehealth services.
• Disparities in the use of services were assessed while adjusting for rurality, race or ethnicity, sex, age, health insurance coverage, and poverty level.

TAKEAWAY:

• Overall, 48% of participants received any mental health treatment; 39% received treatment by a specialist clinician, 25% received prescription medication, 31% used school-based services, and 35% used telehealth services.
• Rural adolescents had significantly lower odds of receiving specialist treatment (adjusted odds ratio [aOR], 0.6) or telehealth services (aOR, 0.6) than urban adolescents (P < .05 for both); participants with private insurance (aOR, 3.3) or public insurance (aOR, 3.4) were significantly more likely to use telehealth services than those with no insurance (P < .05 for both).
• Black adolescents had markedly lower odds of receiving any mental health treatment (aOR, 0.4), treatment by a specialist clinician (aOR, 0.4), and prescription medication (aOR, 0.3) than non-Hispanic White adolescents (P < .05 for all).
• Girls had higher odds than boys of receiving any mental health treatment (aOR, 1.6), treatment by a specialist clinician (aOR, 1.52), and prescription medication (aOR, 1.5) than boys (P < .05 for all).

IN PRACTICE:

“Our findings continue to illustrate the persisting inequity in mental health treatment among adolescents from marginalized groups,” the investigators wrote.

“Policy and clinical initiatives should be informed by further research into how cultural and systemic factors influence the utilization of mental health services and help-seeking behaviors in race/ethnic minority populations,” they added.

SOURCE:

The study was led by Su Chen Tan, University of Tennessee, Knoxville, Tennessee. It was published online on August 20 in PLOS Mental Health.

LIMITATIONS:

The study was limited by its cross-sectional and self-reported design, which precluded causal inferences and may have led to recall bias. Its past-year MDE metric did not distinguish active from remitted cases nor gauged severity, and only binary gender options were offered, excluding nonbinary youth. High-risk groups, including unsheltered homeless, incarcerated, and institutionalized adolescents, were excluded. Additionally, small sample sizes forced aggregation of diverse minorities, and mixed web/in-person modes complicated the comparisons with earlier surveys.

DISCLOSURES:

The study was funded by a National Science Foundation (NSF) grant as part of the US NSF Center for Analysis and Prediction of Pandemic Expansion. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.