Slipping through the Cracks: Predictors of Mental Health Service Use By Black Youth Struggling with Depressive Symptomatology

Background and Purpose: One of the Grand Challenges for Social Work is to ensure healthy development for all youth. Under this Grand Challenge is a focus on the prevention of schizophrenia and severe mental illness. The first step in preventing our youth from developing severe mental illnesses is to ensure that they receive care before they meet criteria for a clinical diagnosis or their disorder becomes unmanageable. Research has shown that Black youth struggling with mental illness are less likely to receive mental health treatment than non-Blacks. However, literature concerning individual factors related to mental health service use specifically by Black youth is sparse. This study uses a national data set to determine whether Black youth struggling with feelings of depression are more likely to receive mental health treatment based on age, engagement in violent behaviors, quality of parental relationship, and experience of suicidal ideation.

Methods: This study used data from the 2017 National Survey of Drug Use and Health. The study sample was made up of 711 Black survey respondents, ages 12-17, that disclosed that there had been a period, lasting several days or longer, when they experienced depressed feelings for most of the day. To determine if there was a relationship between any of the predictor variables and the dependent variable of mental health treatment receipt, two types of analyses were run. The relationship between age and treatment receipt was assessed using a logistic regression. Chi-square analyses were used to examine the individual relationships between the predictor variables of age, engagement in violent behavior, the experience of suicidal ideation, and quality of parental relationship and the dependent variable of mental health treatment receipt.

Results: In this sample, only 35.8% of Black youth that struggled with feelings of depression received any type of mental health treatment. The results showed that Black youth struggling with feelings of depression were no more likely to receive mental health treatment based on their age, the quality of their relationship with their parent/guardian, or whether they contemplated suicide when these emotions were severe. However, youth were more likely to receive treatment if they had attacked someone with the intent to seriously harm them at least once in the past year, ꭓ² = 12.43, df = 1, p < .001.

Conclusions and Implications: Often social workers and other mental health professionals are not called on to provide care until youths’ mental health struggles have reached clinical or dysfunctional levels. This study focused on youth labeled as experiencing feelings of depression instead of those labeled as experiencing full blown major depressive episodes. This was done to determine whether there were any characteristics that increased the odds of receiving early intervention. Unfortunately, it appears the only way that an adolescent struggling with early depressive symptomatology can get help is if they engage in negative externalizing behaviors. It is imperative that social work scholars and practitioners collaborate to develop better screening methods so that youth can receive the necessary mental health care before their condition leads to dysfunction.