School Mental Health

, Volume 7, Issue 2, pp 120–131

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


    • Department of Social WorkAppalachian State University
  • Mimi V. Chapman
    • University of North Carolina at Chapel Hill School of Social Work
Original Paper

DOI: 10.1007/s12310-014-9132-x

Cite this article as:
Williams, K.A. & Chapman, M.V. School Mental Health (2015) 7: 120. doi:10.1007/s12310-014-9132-x


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.


School-based mental health servicesSexual minority youthLesbian, gay, bisexual, and transgender (LGBT)AdolescentsMultilevel analysisMental health service use

Copyright information

© Springer Science+Business Media New York 2014