Patterns of Mental Health Service Utilization in Latino Populations From Childhood Through Emerging Adulthood

• In Event: 1-039 - Addressing Mental Health Needs in Vulnerable Youth

Integrative Statement

Introduction.
Per the Pew Hispanic Center, one in every four newborns is Latino (Flores et al., 2017). Research indicates that Latinos living in the United States, including children and adolescents, have higher rates of unmet mental health need than their non-Latino White peers (Alegria et al., 2002; Cummings & Druss, 2011; Guo et al., 2014). Yet, few longitudinal studies have investigated whether childhood mental health service use is associated with subsequent service use in adulthood. This study examines whether mental health service utilization in childhood and adolescence is associated with service access in emerging adulthood among Latino youth.

Method.
Data come from the Boricua Youth Study, a longitudinal study of Puerto Rican youth at two sites: South Bronx, New York, and the standard metropolitan areas of San Juan and Caguas, Puerto Rico (Bird et al., 2006). Participants included parents and their children who self-identified as Puerto Rican. Parents reported on child mental health and service use in three waves during childhood and adolescence (Waves 1-3; each 1 year apart). Follow-up interviews were conducted with the youth, who were now young adults, eleven years later (Wave 4; N=2,004). In young adulthood, they were surveyed about past-year mental health and service use. A series of binary logistic regression models estimated the association between mental health service use in childhood and at young adulthood.

Results.
Parents reported that 29.8% of youth received services at some point during childhood or adolescence. Of those receiving services, 46.1% received services at one wave of data collection only, 29.3% received services at two waves, and 24.6% received services at all three waves. However, at Wave 4, only 10.7% of young adults with any 12-month disorder had received mental health services in the past year. Rates of unmet need were particularly high among males and those with substance use disorders.
Childhood receipt of mental health services at 2 or more waves of data collection was significantly associated with 12-month outpatient mental health service receipt in young adulthood (OR=2.0, 95% CI=1.1-4.7), even when controlling for demographic variables (gender, socioeconomic status, age, and health insurance), psychiatric diagnosis, and current psychological distress. Sensitivity analyses adding parent reports of childhood internalizing and externalizing disorders during Waves 1-3 found that 2 or more waves of childhood mental health service use remained significantly associated with service use in young adulthood even when accounting for childhood disorders (OR=2.2, 95% CI=1.1-4.7).

Conclusion.
Consistent with prior research, results indicate that Latino youth are substantially under-treated for mental disorders. Although most youth did not receive any mental health services, those who did were more likely to access treatment if they had received services across multiple years of childhood. Improving access to care in childhood may increase service use among young adults with psychiatric disorders. Early identification of psychiatric disorders and outreach targeting Latino children and families may significantly affect young adult decision-making regarding mental health service utilization.

Authors

• Rachel Oblath, Boston University
  Presenting Author

• Jennifer Greif Green, Boston University
  Non-Presenting Author

• Ye Wang, Massachusetts General Hospital
  Non-Presenting Author

• Kiara Alvarez, Massachusetts General Hospital
  Non-Presenting Author

• Glorisa Canino, Universidad de Puerto Rico, Recinto de Ciencias Medicas
  Non-Presenting Author

• Cristiane Duarte, Columbia University Medical Center/New York State Psychiatric Institute
  Non-Presenting Author

• Margarita Alegria, Massachusetts General Hospital
  Non-Presenting Author