3 - (Sym 113) Access to Mental Health Support Among LGBQ+ Youth of Color During COVID-19: Roles of State-level Racism, Homophobia, Provider Shortages, and Income Inequality

Background. Many youth with mental health needs face barriers to accessing treatment. This is especially stark for multiply-marginalized youth, like queer youth of Color (QYoC). Extant work on treatment access has centered White youth and person-level predictors and lacked assessments of youth sexual orientation. Thus, we examined structural predictors of mental health support access during COVID-19 among QYoC with elevated depressive symptoms in the U.S. 

Methods. We used QYoC-identifying adolescents’ self-report data from an online survey (N = 470; 6% American Indian, 22% Asian, 20% Black, 5% Native Hawaiian, 57% Latinx, 16% White; 100% LGBQ+; ages 13-16). Multinomial logistic regression tested links between 5 state-level indicators (structural anti-Black racist attitudes, homophobic attitudes, and their interaction; income inequality; mental health provider shortage severity) and whether QYoC always, sometimes, or never accessed mental health support during COVID-19. 

Results. Among QYoC who wanted mental health support during the pandemic, 43% never, 40% sometimes, and 16% always accessed it. QYoC in states with greater mental health provider shortages more often reported never (vs always; OR=1.52, p < .001) or sometimes (vs always; OR=1.34, p< .05) accessing desired support. A significant racism*homophobia interaction indicated that QYoC living in areas with lower homophobia and lower anti-Black racism more often reported always (vs sometimes) accessing support. State-level provider shortage was the only significant predictor of QYoC reporting they never (vs always) accessed mental health support.

Conclusions. Findings suggest sizable access barriers for QYoC; mental health provider shortages exhibited strong effects. Online interventions may be beneficial for QYoC in these states. QYoC in states with less anti-Black racism and homophobia reported “always” accessing support at high rates. Thus, for QYoC in areas with fewer provider shortages, low structural stigma may support mental healthcare access.