Ethnic and racial differences in mental health service utilization for suicidal ideation and behavior in a nationally representative sample of adolescents
Open accessAbstract
Background This study examined racial/ethnic differences in mental health treatment utilization for suicidal ideation and behavior in a nationally representative sample of adolescents.Method 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.Results 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.Limitations The cross-sectional data limits our ability to form causal inferences.Conclusion 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.
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Youth of color at risk for suicidal thoughts and behaviors have lower rates of access to mental health services or longer delays compared to White peers.
“At the same time, studies find lower rates of access to mental health services or delays in service access for youth of color at risk for suicidal thoughts and behaviors compared to their White peers (3–8).”
From Structural Racism and Suicide Prevention for Ethnoracially Minoritized Youth: A Conceptual Framework and Illustration Across Systems (2022) · cites this paper as [6]
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- Authors
- Nestor, B. A., Cheek, S. M., & Liu, R. T.
- Affiliations
- Brown University (US)
- Corresponding author
- Nestor, Bridget A.
- Liu, Richard T.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2016-09
- Volume
- 202
- Pages
- 197-202
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC4947425
- OpenAlex
- W2399205903
- Cited by
- 81
- References
- 29
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 10 · 2023: 13 · 2022: 11 · 2021: 14 · 2020: 12 · 2019: 4 · 2018: 5
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Centers for Disease Control and Prevention
- National Institute of Mental Health (R01MH101138)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- suicidal ideation, suicide attempts, adolescents, racial and ethnic disparities, mental health service utilization, treatment gap, depression, Native Americans, non-Hispanic blacks, Latino youth, outpatient psychiatric care, hospitalization, symptom severity, health insurance
- MeSH terms
- Adolescent, Black or African American, Cross-Sectional Studies, Depression, Ethnicity, Female, Hispanic or Latino, Humans, Male, Mental Health Services, Minority Groups, Suicide, Attempted, United States, Logistic Models, Black People, White People, Suicidal Ideation
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