The Utilization Needs of School Mental Health Services among Adolescents

Overview: The current study utilized the 2019 National Survey of Drug Use and Health to explore patterns of school mental health service needs and the individual characteristics that may vary by service need patterns among adolescents in middle and high school.Proposal text: Schools have come to the forefront as a primary access point for mental health services to cover the gap between need and service use that has long existed, particularly among vulnerable populations. With the increasing concern regarding adolescent mental health due to the COVID-19 pandemic, it is critical that social workers and other mental health professionals in schools help students in need access appropriate services. This study aims to identify the patterns of school mental health (SMH) service needs and understand the characteristics associated with the service need patterns.
We utilized the 2019 National Survey of Drug Use and Health (NSDUH). The sample included adolescents in 6th through 12th grade (Mean age = 14.38) who had received SMH services in the last 12 months (N = 1,756). 48.2% of participants identified as non-Hispanic White, with 16.5% and 23.5% identifying as non-Hispanic Black and Hispanic, respectively. A latent class analysis (LCA) was conducted to identify the patterns of SMH service needs with 12 indicators that represented the reason(s) of using SMH service in the last 12 months (i.e., depressed, broke the rules, home or family problems). After identifying the patterns, we conducted multinomial logistic regression analyses using Vermunt’s 3-step approach to examine the associations between the patterns of service need and individual characteristics; two separate analyses were run by a major depressive episode (MDE) in the last year.
The analysis suggested 3 patterns of service need: depression (30.4%), high endorsement in most indicators (depressed, family, friend, and peer problems; 7.4%), and low endorsement (62.2%). Among those who had a MDE, female adolescents were significantly classified to the high endorsement class compared to low endorsement (b = 1.01, p = 0.01), while those with a lifetime MDE were significantly classified to the low endorsement class than the high endorsement (b = -1.91, p < 0.001) or depression classes (b = -1.34, p < 0.001). Students using other providers for mental health services were also significantly classified to the low endorsement class compared to the high (b = -1.25, p = .001) or depressive needs class (b = -1.25, p < 0.001). In the group without a MDE, parent support was significantly lower for the high (b = -0.04, p = 0.02) and depression (b = -0.18, p = 0.02) classes compared to low endorsement class. Interestingly, lower levels of risk-taking were significantly classified to the high endorsement class compared to the low endorsement (b = -0.299, p = 0.048). Older adolescents were significantly classified to the depression class compared to low endorsement (b = 0.32, p = 0.03), while those with other mental health services were significantly classified to the low endorsement class compared to the depressive needs class (b = -1.06, p < 0.001). The study reveals important information regarding school mental health professional practice and the different characteristics that lead to service use, which can support schools in how to help students seek services when they are in need and further be able to identify needs among their students.