Ethnic and racial differences in mental health service utilization for suicidal ideation and behavior in a nationally representative sample of adolescents.
This study examined racial/ethnic differences in mental health treatment utilization for suicidal ideation and behavior in a nationally representative sample of adolescents.



Data were drawn from the National Survey on Drug Use and Health. Participants included 4176 depressed adolescents with suicidal ideation and behavior in the previous year. Weighted logistic regressions were estimated to examine whether adolescent racial/ethnic minorities had lower rates of past-year treatment for suicidal ideation and behavior in inpatient or outpatient settings, while adjusting for age, depressive symptom severity, family income, and health insurance status.



Among adolescents with any suicidal ideation and behavior, and suicide attempts specifically, non-Hispanic blacks and Native Americans were less likely than whites to receive outpatient treatment, and multiracial adolescents were less likely to be admitted to inpatient facilities. Apart from Hispanics, racial/ethnic minorities were generally less likely to receive mental health care for suicidal ideation, particularly within psychiatric outpatient settings. A pattern emerged with racial/ethnic differences in treatment receipt being greatest for adolescents with the least severe suicidal ideation and behavior.



The cross-sectional data limits our ability to form causal inferences.



Strikingly low rates of treatment utilization for suicidal ideation and behavior were observed across all racial/ethnic groups. Certain racial/ethnic minorities may be less likely to seek treatment for suicidal ideation and behavior when symptoms are less severe, with this gap in treatment use narrowing as symptom severity increases. Native Americans were among the racial/ethnic groups with lowest treatment utilization, but also among the highest for rates of suicide attempts, highlighting the pressing need for strategies to increase mental health service use in this particularly vulnerable population.
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI 02915, USA. Electronic address: bridget_nestor@brown.edu.
Bridget A
BA
Nestor
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI 02915, USA.
Shayna M
SM
Cheek
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Bradley Hospital, 1011 Veterans Memorial Parkway, East Providence, RI 02915, USA. Electronic address: rtliupsych@gmail.com.
Richard T
RT
Liu
D000293:Adolescent; D044383:Black People / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003863:Depression / Q000208:ethnology* / Q000628:therapy*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000706:statistics & numerical data; D059020:Suicidal Ideation; D013406:Suicide, Attempted / Q000517:prevention & control* / Q000706:statistics & numerical data; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
Adolescence; Ethnicity; Mental health services; Race; Suicidal ideation and behavior