Skip to main content

Advertisement

SpringerLink
Log in

Mental Health Service Use Among Youth with Mental Health Need: Do School-Based Services Make a Difference for Sexual Minority Youth?

  • Original Paper
  • Published:
School Mental Health Aims and scope Submit manuscript

Abstract

Evidence suggests that despite higher rates of mental health service use, sexual minority youth (SMY) have greater unmet mental health need than peers. Using a representative subsample of students with a mental health need from the National Longitudinal Study of Adolescent Health (n = 8,034), a multilevel analysis was conducted to explore whether: (1) Availability of school mental health services affects the odds that youth with a mental health need will use mental health services; and whether (2) sexual minority status (SMS) interacts with availability of school mental health services to moderate the relationship between SMS and mental health service use. SMY accounted for 10.3 % (n = 766) of the subsample. Mental health need was defined using measures for physical and sexual victimization, anxiety, depression, and suicidality. A hierarchical logistical regression tested for cross-level interaction (SMS × school mental health services). SMY had 82 % higher odds of using mental health services in any sector than their heterosexual peers (OR = 1.82, p < .001). Overall, youth with a mental health need had 40 % higher odds of using any type of mental health services if they attended schools offering mental health services (OR = 1.40, p < .001). The cross-level interaction test between SMS and service use was nonsignificant. Model-predicted probabilities are presented to better understand the findings. School-based mental health services are a crucial gateway to mental health service use in any sector for youth with a mental health need regardless of SMS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • American Psychological Association. (2001). Needs assessment survey study: Evaluation and training needs of school staff relevant to prevent risk behaviors and promoting healthy behaviors among lesbian, gay, and bisexual youth and those youth desiring or engaging in same-sex sexual behaviors. Paper presented by Caitlyn Ryan at the Health Lesbian, Gay, and Bisexual Student Project Meeting. Washington, DC.

  • Angold, A., Messer, S. C., Stangl, D., Farmer, E. M. Z., Costello, E. J., & Burns, B. J. (1998). Perceived parental burden and service use for child and adolescent psychiatric disorders. American Journal of Public Health, 88, 75–80. doi:10.2105/AJPH.88.1.75.

    Article  PubMed Central  PubMed  Google Scholar 

  • Bontempo, D. E., & D’Augelli, A. R. (2002). Effects of at-school victimization and sexual orientation on lesbian, gay, or bisexual youths’ health risk behavior. Journal of Adolescent Health, 30, 364–374. doi:10.1016/S1054-139X(01)00415-3.

    Article  PubMed  Google Scholar 

  • Bronfenbrenner, U. (1989). Ecological systems theory. In R. Vasta (Ed.), Annals of child development (Vol. 6, pp. 187–249). Greenwich, CT: JAI Press.

    Google Scholar 

  • Cauce, A. M., & Srebnik, D. (2003). Before treatment: Adolescent mental health help-seeking. Prevention Researcher, 10(4), 6–9. Retrieved from http://www.tpronline.org/article.cfm/Before_Treatment_Adolescent_Mental_Health_Help_Seeking.

  • Committee on School Health. (2004). School-based mental health services. Pediatrics, 113, 1839–1845. doi:10.1542/peds.113.6.1839.

    Article  Google Scholar 

  • Costello, E. J. (2006). The great smoky mountains study: A detailed picture of children’s mental health services in western North Carolina. In N. Douglass, J. Owen, & L. J. Berlin (Eds.). Children’s mental health: Strategies for providing high-quality and cost-effective care. http://childandfamilypolicy.duke.edu/pdfs/familyimpact/2006/BriefingReport_06.pdf.

  • Costello, E. J., Egger, H., & Angold, A. (2005). 10-year research update review: The epidemiology of child and adolescent psychiatric disorders: I. Methods and public health burden. Journal of Child & Adolescent Psychiatry, 44(10), 972–986. doi:10.1097/01.chi.0000172552.41596.6f.

    Article  Google Scholar 

  • Costello, E. J., Pescosolido, B. A., Angold, A., & Burns, B. J. (1998). A family network-based model of access to child mental health services. Research in Community and Mental Health, 9, 165–190.

    Google Scholar 

  • Farmer, E., Burns, B. J., Phillips, S., Angold, A., & Costello, E. J. (2003). Pathways into and through mental health services for children and adolescents. Psychiatric Services, 54, 60–66. doi:10.1176/appi.ps.54.1.60.

    Article  PubMed  Google Scholar 

  • Faulkner, A. H., & Cranston, K. (1998). Correlates of same-sex sexual behavior in a random sample of Massachusetts high schools students. American Journal of Public Health, 88, 262–266. doi:10.2105/AJPH.88.2.262.

    Article  PubMed Central  PubMed  Google Scholar 

  • Ford, C. A., Pence, B. W., Miller, W. C., Resnick, M. D., Bearinger, L. H., Pettingell, S., et al. (2005). Predicting adolescents’ longitudinal risk for sexually transmitted infection. Archives of Pediatrics and Adolescent Medicine, 159, 657–664. doi:10.1001/archpedi.159.7.657.

    Article  PubMed  Google Scholar 

  • Garofalo, R., Wolf, R. C., Kessel, S., Palfrey, S. J., & DuRant, R. H. (1998). The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics, 101, 895–902. doi:10.1542/peds.101.5.895.

    Article  PubMed  Google Scholar 

  • Garrison, C. Z., Addy, C. L., Jackson, K. L., McKeown, R. E., & Waller, J. L. (1991). The CES-D as a screen for depression and other psychiatric disorders in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 636–641. doi:10.1097/00004583-199107000-00017.

    Article  PubMed  Google Scholar 

  • Goodenow, C., Szalacha, L., & Westheimer, K. (2006). School support groups, other school factors, and the safety of sexual minority adolescents. Psychology in the Schools, 43, 573–589. doi:10.1002/pits.20173.

    Article  Google Scholar 

  • Greenberg, M. T., Weissberg, R. P., O’Brien, M. U., Zins, J. E., Fredericks, L., Resnik, H., et al. (2003). Enhancing school-based prevention and youth development through coordinated social, emotional, and academic learning. American Psychologist, 58, 466–474. doi:10.1037/0003-066X.58.6-7.466.

    Article  PubMed  Google Scholar 

  • Greytak, E. A., Kosciw, J. G., & Boesen, M. J. (2013). Educating the educator: Creating supportive school personnel through professional development. Journal of School Violence, 12(1), 80–97. doi:10.1080/15388220.2012.731586.

    Article  Google Scholar 

  • Kataoka, S., Stein, B. D., Nadeem, E., & Wong, M. (2007). Who gets care? Mental health service use following a school-based suicide prevention program. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1341–1348. doi:10.1097/chi.06013e31813761fd.

    Article  PubMed  Google Scholar 

  • Kosciw, J. G., Greytak, E. A., Bartkiewicz, M. J., Boesen, M. J., & Palmer, N. A. (2012). The 2011 national school climate survey: The experiences of lesbian, gay, bisexual and transgender youth in our nation’s schools. New York, NY: GLSEN.

    Google Scholar 

  • Kosciw, J. G., Palmer, N. A., Kull, R. M., & Greytak, E. A. (2013). The effect of negative school climate on academic outcomes for LGBT youth and the role of in-school supports. Journal of School Violence, 12(1), 45–63. doi:10.1080/15388220.2012.732546.

    Article  Google Scholar 

  • Laumann, E. O., Gagnon, J. H., Michael, R. T., & Michaels, S. (1994). The social organization of sexuality: Sexual practices in the United States. Chicago, IL: University of Chicago Press.

    Google Scholar 

  • Logan, D. E., & King, C. A. (2001). Parental facilitation of adolescent mental health service utilization: A conceptual and empirical review. Clinical Psychology: Science and Practice, 8, 319–333. doi:10.1093/clipsy.8.3.319.

    Google Scholar 

  • Lyon, A. R., Ludwig, K. A., Vander Stoep, A., Gudmundsen, G., & McCauley, E. (2013). Patterns and predictors of mental healthcare utilization in schools and other service sectors among adolescents at risk for depression. School Mental Health, 5, 155–165. doi:10.1007/s12310-012-9097-6.

    Article  Google Scholar 

  • McGuire, J., & Russell, S. T. (2007). Health care utilization by sexual minority adolescents. Journal of Adolescent Health, 40, S28–S28. doi:10.1016/j.jadohealth.2006.11.074.

    Article  Google Scholar 

  • Merikangas, K. R., He, J. P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the national comorbidity survey replication—adolescent supplement (NCS—A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(19), 980–989. doi:10.1016/j.jaac.2010.05.017.

    Article  PubMed Central  PubMed  Google Scholar 

  • Paternite, C. E. (2004). Involving educators in school-based mental health programs. In K. E. Robinson (Ed.), School-based mental health: Best practices and program models (pp. 6–21). Kingston, NJ: Research Institute Inc.

    Google Scholar 

  • Paternite, C. E. (2005). School-based mental health programs and services: Overview and introduction to the special issue. Journal of Abnormal Child Psychology, 33, 657–663. doi:10.1007/s10802-005-7645-3.

    Article  PubMed  Google Scholar 

  • Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306.

    Article  Google Scholar 

  • Ream, G. L., & Savin-Williams, R. C. (2005). Reciprocal associations between adolescent sexual activity and quality of youth-parent interactions. Journal of Family Psychology, 19, 171–179. doi:10.1037/0893-3200.19.2.171.

    Article  PubMed  Google Scholar 

  • Roans, M., & Hoagwood, K. (2000). School-based mental health services: A research review. Clinical Child and Family Psychology Review, 3, 223–241. doi:10.1023/A:1026425104386.

    Article  Google Scholar 

  • Roberts, R. E., Lewinsohn, P. M., & Seeley, J. R. (1991). Screening for adolescent depression: A comparison of depression scales. Journal of American Academy of Child and Adolescent Psychiatry, 30, 58–66. doi:10.1097/00004583-199101000-00009.

    Article  Google Scholar 

  • Russell, S. T. (2006). Substance use and abuse and mental health among sexual-minority youths: Evidence from Add Health. In A. M. Omoto & H. S. Kurtzman (Eds.), Sexual orientation and mental health: Examining identity and development in lesbian, gay, and bisexual people (pp. 13–35). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Russell, S. T., Franz, B. T., & Driscoll, A. K. (2001a). Same-sex romantic attraction and experiences of violence in adolescence. American Journal of Public Health, 91, 903–906.

    Article  PubMed Central  PubMed  Google Scholar 

  • Russell, S. T., & Joyner, K. (2001). Adolescent sexual orientation and suicide risk: Evidence from a national study. American Journal of Public Health, 91, 1276–1281. doi:10.2105/AJPH.91.8.1276.

    Article  PubMed Central  PubMed  Google Scholar 

  • Russell, S. T., Seif, H., & Truong, N. L. (2001b). School outcomes of sexual minority youth in the United States: Evidence from a national study. Journal of Adolescence, 24, 111–127. doi:10.1006/jado.2000.0365.

    Article  PubMed  Google Scholar 

  • Ryan, C., & Futterman, D. (1998). Lesbian and gay youth: Care and counseling. New York: Columbia University Press.

    Google Scholar 

  • Saewyc, E. M., Bearinger, L. H., Blum, R. W., & Resnick, M. D. (1999). Sexual intercourse, abuse and pregnancy among adolescent women: Does sexual orientation make a difference? Family Planning Perspectives, 31, 127–131. doi:10.2307/2991695.

    Article  PubMed  Google Scholar 

  • Simpson, G. A., Scott, G., Henderson, M. J., & Manderscheid, R. W. (2002). Estimates of attention, cognitive, and emotional problems, and health service use by U. S. school-age children. In R. W. Manderscheid & M. J. Henderson (Eds.), Mental, health, United States 2002 (pp. 105–119). Rockville, MD: US Department of Health and Human Services Substance Abuse and Mental Health Services Administration Center for Mental Health Services.

    Google Scholar 

  • Slade, E. C. (2002). Effects of school-based mental health programs on mental health service use by adolescents at school and in the community. Mental Health Services Research, 4, 151–166. doi:10.1023/A:1019711113312.

    Article  PubMed  Google Scholar 

  • Sribney, W. (2005). Stepwise regression with the svy commands. Retrieved March 5, 2009, from http://www.stata.com/support/faqs/stat/stepsvy.html.

  • Takeuchi, D. T., Bui, K. V. T., & Kim, L. (1993). The referral of minority adolescents to community mental health centers. Journal of Health and Social Behavior, 34, 153–164.

    Article  PubMed  Google Scholar 

  • Toomey, R. B., Ryan, C., Diaz, R. M., Card, N. A., & Russell, S. T. (2010). Gender-nonconforming lesbian, gay, bisexual and transgender youth: School victimization and youth adult psychosocial adjustment. Developmental Psychology, 46, 1580–1589. doi:10.1037/a0020705.

    Article  PubMed  Google Scholar 

  • Toomey, R. B., Ryan, C., Diaz, R. M., & Russell, S. T. (2011). High school gay–straight alliances (GSAs) and young adult well-being: An examination of GSA presence, participation, and perceived effectiveness. Applied Developmental Science, 15(4), 175–185. doi:10.1080/10888691.2011.607378.

    Article  PubMed Central  PubMed  Google Scholar 

  • Udry, J. R., & Chantala, K. (2002). Risk assessment of adolescents with same-sex relationships. Journal of Adolescent Health, 31, 84–92. doi:10.1016/S1054-139X(02)00374-9.

    Article  PubMed  Google Scholar 

  • Walls, N. E., Kane, S. B., & Wisneski, H. (2009). Gay-straight alliances and school experiences of sexual minority youth. Youth & Society, 41(3), 307–332. doi:10.1177/0044118X09334957.

    Article  Google Scholar 

  • Williams, K. A., & Chapman, M. V. (2011). Comparing health and mental health needs, service use, and barriers to services among sexual minority youth and their peers. Health and Social Work, 36, 197–206. doi:10.1023/A:1019711113312.

    Article  PubMed  Google Scholar 

  • Williams, K. A., & Chapman, M. V. (2012). Unmet health and mental health need among adolescents: The roles of sexual minority status and child–parent connectedness. American Journal of Orthopsychiatry, 82, 473–481. doi:10.1111/j.1939-0025.2012.01182.x.

    Article  PubMed  Google Scholar 

  • Wood, D. L., Hayward, R. A., Corey, C. R., Freeman, H. E., & Shapiro, M. F. (1990). Access to medical care for children and adolescents in the United States. Pediatrics, 86, 666–673.

    PubMed  Google Scholar 

  • Ziyadeh, N. J., Prokop, L. A., Fisher, L. B., Rosario, M., Field, A. E., Camargo, C. A., et al. (2007). Sexual orientation, gender, and alcohol use in a cohort study of U.S. adolescent girls and boys. Drug and Alcohol Dependence, 87, 119–130. doi:10.1016/j.drugalcdep.2006.08.004.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Social Work, Appalachian State University, Boone, NC, USA

    Kelly A. Williams

  2. University of North Carolina at Chapel Hill School of Social Work, Chapel Hill, NC, USA

    Mimi V. Chapman

Authors
  1. Kelly A. Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mimi V. Chapman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kelly A. Williams.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Williams, K.A., Chapman, M.V. Mental Health Service Use Among Youth with Mental Health Need: Do School-Based Services Make a Difference for Sexual Minority Youth?. School Mental Health 7, 120–131 (2015). https://doi.org/10.1007/s12310-014-9132-x

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12310-014-9132-x

Keywords

Search

Navigation