Foregone Preventive Care and Unmet Mental Healthcare Needs Among U.S. Youth.

Abstract

Given the youth mental health crisis, this study examines racial and ethnic disparities of foregone preventive care, unmet mental healthcare needs, and difficulty accessing mental healthcare among youth with common mental health problems. A cross-sectional analysis was conducted using the 2022 National Survey of Children's Health (NSCH), examining U.S. youth aged 8-17 years with parent-reported anxiety, depression, or behavioral problems. NSCH survey weights were utilized, and ORs were estimated for each racial and ethnic group across foregone preventive care, unmet mental healthcare needs, and difficulty obtaining mental healthcare, adjusting for age, sex, language, income, parental education, and insurance. Among the weighted sample of 6,608 youth with common mental health problems, 14.2% of children with common mental health problems had forgone preventive care, 15.1% had unmet mental healthcare needs, and 59.2% had difficulty obtaining mental healthcare. Per parental report, Black children had 1.59 (95% CI=1.01, 2.51) times the odds of foregoing preventive care in the past year compared to White children. Asian children had 2.32 (1.18, 4.48) times the odds of unmet mental healthcare compared to White children. There were no significant differences in difficulty obtaining mental healthcare across race and ethnicity. Racial and ethnic disparities exist in accessing preventive and mental healthcare among children with parent-reported mental health conditions. Black youth have higher rates of foregone preventive care, while Asian youth have higher unmet mental healthcare needs compared to White youth. Further research should explore barriers and facilitators of collaborative care to reduce youth mental healthcare disparities.