Adolescent Exposure to Community Violence and Depressive Symptoms Among Adolescents and Young Adults: Understanding the Effect of Mental Health Service Usage
Although empirical studies have established the connection between adolescent exposure to community violence and mental health conditions such as anxiety, depression, externalizing and internalizing behaviors, adolescents exposed to community violence rarely receive mental health services (Guterman, Hahm, Cameron, 2002; Turner, Finkelhor, Ormrod, 2007), little is known about the type of community violence victimization experiences that lead to mental health service utilization, and at what life stage an individual might seek mental health services help. Moreover, we lack understanding regarding whether access and use of such services could improve mental health conditions among adolescent community violence victims across life stages.
The present study aims to: (1) assess whether adolescent’s victimization is linked with mental health service use during adolescence and later in life after controlling for important background information; and (2) examine the role of mental health service use in attenuating the short term and long term negative psychological influences from these early adverse life experiences. This study hypothesizes that victimized adolescents would be more likely to use mental health service than non-victims and that service utilization varies by types of violence exposure. In addition, this study hypothesizes that use of mental health services would reduce depressive symptoms resulting from exposure to violence in community.
Methods:
We use four waves of data from the National Longitudinal Study of Adolescent Health (Add Health). Weighted mediation analyses were conducted to to investigate the link between adolescent’s various types of community violence victimization, mental health service use, and depressive symptoms during adolescence and young adulthood respectively.
Results:
Direct personal victimization and a combination of direct victimization and witnessing of community violence were predictive of reports of depressive symptoms both during adolescence and young adulthood while controlling for individual sociodemographic background, family support, connection to others, school connectedness, community connectedness, suicidal attempts and hard drug use. Adolescent direct victimization experiences were associated with mental health service use both during adolescence and young adulthood. Use of mental health service did not significantly attenuate the influence from direct victimization on adolescent depressive symptom; however, a marginal mediating effect by adult use of mental health service was observed between combined adolescent victimization experience and adult depressive symptoms.
Conclusions and Implications:
Associations between adolescent community violence exposure and mental health service utilization vary by types of exposure. Adolescent victimization by community violence has both short term and long term effects on reports of depressive symptoms.
These findings emphasize the need to distinguish productive gateways to adult mental health services while delineating comparable or unique strategies tailored to adolescents’ access to mental health services
Further insights into mental health service utilization patterns by victims of community violence at different life stages may illuminate critical prevention intervention opportunities that can be seized upon by practitioners and policy makers.