Barriers and Facilitators for Mental Health Service Use Among Racial/Ethnic Minority Adolescents: A Systematic Review of Literature

Abstract

Introduction: Mental disorders represent serious public health concerns in the U.S. Compared with Whites, racial/ethnic minority adolescents are more likely to be affected by mental disorders but less likely to use mental health services. This systematic review aimed to summarize factors related to mental health service use among minority adolescents in the U.S. as identified in previous research.Methodology: Following the PRISMA guideline, we systematically searched seven databases for peer reviewed articles related to barriers and facilitators of mental health service use among racial/ethnic minority adolescents.Results: Thirty-two quantitative studies met our inclusion criteria, among which 12 studies (37.5%) sampled mostly Blacks or African Americans, 6 studies (18.7%) focused primarily on Hispanics or Latin/a/x, including Mexican Americans and Puerto Ricans, and 4 studies (12.5%) were mostly Asian Americans (e.g., Chinese, Vietnamese). Based on the socio-ecological framework, 21 studies (65.6%) identified adolescent-related barriers and facilitators of mental health service use, including biological (e.g., age, gender), clinical (e.g., symptom severity), behavioral (e.g., drug/alcohol use), and psychological characteristics (e.g., internal asset) of minority youth. Ten studies (31.3%) identified parents-related factors that influenced minority adolescent mental health service use, including parental perceptions and beliefs, family and parenting issues, and demographic characteristics. Primary factors at the therapist level included ethnic match between patient and practitioner, relationship with healthcare practitioners, and patient-therapist co-endorsement of etiological beliefs. Fifteen studies (46.9%) identified factors influencing minority adolescent mental health service use at the contextual/structural level, including household income, insurance status, and family structure. Lastly, acculturation and school experiences were major factors at the social/cultural level that influence minority adolescent service use.Conclusion: More empirical studies are needed to understand the mechanism underlying minority adolescents' unmet mental health service needs. Culturally competent interventions are warranted to engage minority adolescents with mental disorders into treatment.

The Depression: Online Therapy Study (D:OTS)—A Pilot Study of an Internet-Based Psychodynamic Treatment for Adolescents with Low Mood in the UK, in the Context of the COVID-19 Pandemic

“…Indeed, research shows that young people from low socioeconomic backgrounds are more likely to experience mental health problems [ 1 ], and in turn, statistics show that minoritised ethnic groups are more likely to be classified in lower socioeconomic status that those who identify themselves as white [ 41 ]. This may suggest that black and minoritised ethnic young people experience specific barriers to seeking mental health services, relating to various intersecting types of disadvantage [ 42 , 43 ]. In the present study, it may be that young people from minoritised ethnic groups felt more comfortable engaging in an internet-based therapy where their own, and their therapist’s, ethnic identity is undisclosed.…”

Psychosocial screening in a pediatric diabetes clinic: Adolescents' and mothers' perspectives

“…Participants wanted mental health services to be offered through the diabetes clinic and emphasized the need for greater support to obtain services outside the clinic. This may be particularly critical for youth from Hispanic/Latinx backgrounds, who may face greater barriers to accessing mental health services 37 . At a minimum, adolescents and their caregivers need their clinic to provide referrals to trusted mental health professionals who have experience with diabetes.…”

“…This may be particularly critical for youth from Hispanic/Latinx backgrounds, who may face greater barriers to accessing mental health services. 37 At a minimum, adolescents and their caregivers need their clinic to provide referrals to trusted mental health professionals who have experience with diabetes. Mothers felt a background in diabetes was very important; yet, only half of mental health professionals working in integrated pediatric diabetes care settings report formal training in the medical management of diabetes.…”

Describing Changes in Telebehavioral Health Utilization and Services Delivery in Rural School Settings in Pre‐ and Early Stages of the COVID‐19 Public Health Emergency

“…In addition to provider shortages, transportation remains one of the largest barriers to accessing behavioral health treatment for children and adolescents, 9 especially for those living in rural areas where families typically travel long distances to get to the nearest behavioral health clinic. Another deterrent for seeking treatment is time, as it is often difficult for parents/guardians to leave or miss work to take their child to appointments 10 . Stigma attached to behavioral health concerns remains a barrier, particularly for some racial and ethnic groups, which limits the number of people seeking care for their children 11 .…”

“…Another deterrent for seeking treatment is time, as it is often difficult for parents/guardians to leave or miss work to take their child to appointments. 10 Stigma attached to behavioral health concerns remains a barrier, particularly for some racial and ethnic groups, which limits the number of people seeking care for their children. 11 A study among parents in rural areas seeking behavioral health services for their children found that stigma led to decreased willingness to seek services from settings like behavioral health centers.…”