Emerging Adult Unmet Mental Health Needs: Identifying Patterns of Barriers to Mental Health Service Utilization

Background and Purpose: Emerging adulthood is a critical developmental period marked by increased risk for the onset of mental health challenges, yet service utilization remains disproportionately low. National data indicate that nearly one in three emerging adults (ages 18–25) experiences a mental illness each year, yet fewer than half receive mental health services. Barriers to seeking mental health services in this age group are multifaceted, including structural, logistical, and attitudinal factors. These barriers can intersect in complex ways, particularly as emerging adults navigate new responsibilities, shifting support systems, and growing autonomy. Despite increased awareness and advocacy around mental health, many young people still delay or forgo needed treatment. Understanding distinct patterns of these barriers is essential to developing more targeted and effective interventions. The purpose of the current study is to explore patterns of barriers among emerging adults to inform strategies that promote timely engagement in mental health care.

Methods: This study used data from the 2023 National Survey of Drug Use and Health (NSDUH). The sample included emerging adults between 18 and 25 years old who reported needing mental health services but not seeking services in the last 12 months (N = 1,027). 61.5% of the sample identified as female and 38.5% as male, with 54.2% identifying as Non-Hispanic White, followed by 24.7% Hispanic, and 8.6% Non-Hispanic Black. For barriers to seeking mental health services, the study used 18 dichotomous indicators (i.e., treatment cost too much, could not find preferred provider, worried what people would say, not enough time). We used Vermunt’s 3-step Latent Class Analysis (LCA) to identify mental health service barrier patterns. We then examined individual characteristics associated with patterns of barriers including race/ethnicity, biological sex, educational level, and having government assistance.

Results: The LCA identified a 3-class model, which included structural and personal barriers (28.2%), access and self-reliance barriers (39.2%), and Internalized barriers (32.6%). The structural and personal barriers class included cost and insurance concerns, concerns about location, privacy, and force within treatment. The access and self-reliance barriers included cost of treatment, not knowing where or how to access services, and thinking one can handle their mental health needs on their own. The Internalized barriers class included concern about what people would think, not being ready for treatment, thinking one can handle needs on their own, and thinking treatment won’t help. Significant individual-level characteristics associated with class belonging will be discussed.

Conclusions and Implications: Our findings highlight existing patterns of barriers for young adults seeking services for their mental health needs. Findings support that while mental health needs continue to increase among emerging adults, barriers for them from seeking treatment exist and need to be addressed. The current study emphasizes the critical need for continued identification of barriers to emerging adults seeking treatment and supporting mental health policies that target provider capacity and specific resources aimed at identifying and dismantling barriers for vulnerable populations.