Patterns of Adolescent Mental Health Service Needs By Service Setting: A Latent Class Analysis

Background and Purpose: Studies have found that approximately half of the mental health needs discovered in adulthood begin during adolescence. Though the rate of mental health needs among adolescents is at an all-time high and continues to increase, there is limited knowledge of what mental health needs lead adolescents to seek services. The current study aims to explore 1) patterns for mental health service needs and 2) predisposing, enabling, and need predictors related to service needs.

Methods: This study used data from the 2019 National Survey of Drug Use and Health (NSDUH). The sample included adolescents between 12 and 17 years old (M = 14.94) in 6th through 12th grade who had received mental health services in the last 12 months (N = 3210). For mental health service needs, the study used 11 dichotomous indicators (i.e., depression, family problems, school problems, eating problems, thoughts of suicide) asking reasons adolescents sought mental health services. We used Vermunt’s 3-step Latent Class Analysis (LCA) to identify mental health service needs patterns and examine individual characteristics associated with the patterns of service need. We conducted separate analyses with three subsamples: those who received services from (1) the school setting only (n = 585), (2) non-school settings only (n =1810), and (3) both school and non-school settings (n = 815).

Results: The LCA identified a three-class model similarly in all subsamples. The three classes included low endorsement, depressive needs, and multiples needs. Yet the distribution of the three classes differed across the subsamples. For example, the depressive needs class consisted of 23% in the non-school service settings, while it did 38% in the school service setting. Multinomial analyses presented that several individual characteristics were associated with the patterns of service need (reference=the low endorsement class). In the school setting, parent support was lower for the depressive needs class. In non-school settings, Black adolescents, those with lower social support, and older adolesecents were more likely to be in the depressive needs or the multiple needs class than the low endorsement class. For those using both service settings, older and female adolescents were more likely to be in the depressive needs or multiple needs classes than the low endorsement class. Also, Black adolescents were less likely to be in the multiple needs class, and parent support decreased the likelihood of being in the depressive needs class among those who received services in both settings.

Conclusions and Implications: Our findings highlight how patterns of service need among adolescents are different by service setting. Findings support that while depression is a common need in any setting, adolescents using school services tend to have peer and school problems with mental health issues. The current study emphasizes the critical need for continued identification of why and where adolescents seek mental health services to best support their ability to address their mental health needs.