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Access to Adolescent Mental Health Care

Adolescents ages 12-17 receive mental health services in a variety of settings. In 2016, 3.6 million received mental health services such as seeing a psychiatrist, psychologist, or counselor in a specialty mental health setting, 3.2 million received services such as counseling or participating in a behavioral health program in an educational setting, and 708,000 received mental health services from a pediatrician or family physician.1

As symptoms of mental illness emerge and develop, they have strong influences on an adolescent’s behavior and can become more difficult to treat. Although effective therapies exist for many mental illnesses, not all adolescents who need treatment receive it.1

Barriers and Disparities in Mental Health Care

In 2016, only 41 percent of the 3.1 million adolescents who experienced depression within the past year received treatment.1 Stigma and cultural norms regarding mental health are some of the barriers to mental health treatment. There also are shortages of child and adolescent psychiatrists in some parts of the United States, particularly in rural areas. Over 15 million children and adolescents need psychiatric help, but only about 8,300 child and adolescent psychiatrists practice in the United States.2 Furthermore, when most adolescents turn 18, they can make decisions about mental health treatment and hospitalization without parental consent.

The following barriers may partially explain why use of mental health services differs by gender, age, race/ethnicity, income, and other characteristics:

  • Female adolescents are more likely than male adolescents to receive mental health services, regardless of setting.3
  • Younger adolescents are more likely than older adolescents (ages 16 to 17) to receive mental health services in an educational setting.3
  • White youth are more likely to receive mental health services compared to youth of color.4
  • Asian adolescents are less likely than adolescents of most other races/ethnicities to receive mental health services, regardless of setting.3
  • A higher proportion of Hispanic youth have unmet mental health needs, compared to their black and white peers.4
  • Lesbian, gay, bisexual, and transgender (LGBT) youth have higher rates of mental disorder diagnoses than other youth in national samples.5
  • Twenty-one percent of youth ages 6 to 17 who live in poverty have mental health disorders.3
  • Youth with any health insurance coverage (private or public) are more likely to receive mental health services than those without coverage.6
  • Adolescents living in rural areas are less likely than those living in urban areas to receive mental health services from a pediatrician or family physician.3
  • Half of all youth in the child welfare system, and nearly 70 percent of youth in the juvenile justice system, have a diagnosable mental health disorder.4
  • Children who are living in foster care have a substantially greater risk of experiencing mental health disorders, especially those connected with traumatic stress, such as abuse and neglect.4


1 U.S. Department of Health and Human Services, Substance Abuse and Mental Health Administration. (2017). Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm
2 American Academy of Child & Adolescent Psychiatry. (2016). Workforce issues. Retrieved from http://www.aacap.org/aacap/resources_for_primary_care/Workforce_Issues.aspx
3 Lipari, R. N., Hedden, S., Blau, G., & Rubenstein, L. (2016). The CBHSQ report: Adolescent mental health service use and reasons for using services in specialty, educational, and general medical settings. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/report_1973/ShortReport-1973.html
4 Interagency Working Group on Youth Programs. (n.d.). Mental health: Prevalence. Retrieved from http://youth.gov/youth-topics/youth-mental-health/prevalance-mental-health-disorders-among-youth
5 Mustanski, B. S., Garofalo, R., & Emerson, E. M. (2010). Mental health disorders, psychological distress, and suicidality in a diverse sample of lesbian, gay, bisexual, and transgender youths. American Journal of Public Health, 100(12), 2426-2432. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2978194/
6 U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (2014). The health and well-being of children: A portrait of states and the nation 2011-2012. Retrieved from http://mchb.hrsa.gov/nsch/2011-12/health/child/childs-health-care/mental-health-care.html
Content created by Office of Adolescent Health
Content last reviewed on January 15, 2019