ETHNORACIAL DISPARITIES IN THE PREVALENCE OF MENTAL HEALTH CONDITIONS AND SERVICE UTILIZATION TRENDS AMONG YOUTH USING THE NATIONAL SURVEY OF CHILDREN’S HEALTH DATA

Metta Kongira

Mental health problems during childhood and adolescence can result in poor social, emotional, and cognitive development, particularly if left untreated (Ghandour et al., 2019). Approximately one in five children in the United States is diagnosed with a mental or behavioral health condition (CDC, 2025). Depression, anxiety problems, and behavior/conduct problems are reported to be the most common conditions among youth aged six to 17 years (Bitsko et al, 2022). Disparities in the prevalence, access to, and utilization of care services remain a challenge, particularly among ethnoracially minoritized populations (Alegría et al., 2016; Cook et al., 2019). The current study utilized the socioecological model (SEM) framework to examine the prevalence of anxiety, depression, and behavior/conduct problems, and assessed the trends in mental health services access and utilization among youth aged six to 17 years from various ethnoracial backgrounds using secondary data from the National Survey of Children’s Health (NSCH). The study sample included 187,460 non-Hispanic White, non-Hispanic Black/African American, Hispanic, or non-Hispanic Other youth. Using Generalized Linear Mixed Models and Chi-square analyses, the study examined prevalence patterns and identified individual, interpersonal, and community-level predictors of service use and difficulty obtaining care.The results revealed that anxiety was the most prevalent condition (14.4%), followed by behavior/conduct problems (8.6%), then depression (6.4%). Prevalence of mental health conditions differed significantly by ethnoracial group and sex (p < 0.001). Anxiety and depression were more prevalent among females, and behavior/conduct problems were more prevalent among males. Among ethnoracial groups, the results showed the highest prevalence of anxiety and depression among Non-Hispanic White youth, whereas non-Hispanic Black youth had the highest prevalence of behavior/conduct problems. Prevalence rates for all mental health conditions did not significantly change over time (2017 to 2023). Multivariate models analysis showed that mental health service receipt was higher among youth from English-speaking households and those exposed to discrimination or neighborhood violence. The likelihood of receiving mental health care was significantly lower if the adult respondent had greater than high school education (OR = 0.830, 95% CI 0.800-0.861, p <0.001 or if the household indicated food insecurity (OR = 0.661, 95% CI 0.617-0.708, p <0.001). Household income level was not a significant predictor of receiving mental health services (OR = 1.023, 95% CI 0.992-1.055, p = 0.153). The main predictors of significant difficulty obtaining mental health services were exposure to discrimination and neighborhood violence (p < 0.001). The study findings highlight the crucial influence of social determinants on mental health disparities and emphasize the importance of targeted interventions to ensure equal access to care services and enhance mental health outcomes for young people.

ETHNORACIAL DISPARITIES IN THE PREVALENCE OF MENTAL HEALTH CONDITIONS AND SERVICE UTILIZATION TRENDS AMONG YOUTH USING THE NATIONAL SURVEY OF CHILDREN’S HEALTH DATA

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