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J Adolesc Health. 2004 Nov;35(5):368-73.

Predictors for emotionally distressed adolescents to receive mental health care.

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  • 1Division of Adolescent Medicine, Strong Children's Research Center, Golisano Children's Hospital at Strong and the AAP Center for Child Health Research, University of Rochester, Rochester, New York 14642, USA.



To determine predictors for emotionally distressed adolescents from different racial/ethnic groups to receive psychological counseling.


This study used secondary database analysis of the restricted-use National Longitudinal Study of Adolescent Health, using predictor variables from Wave 1 and the outcome variable from Wave 2. Adolescents scoring in the top third of an emotional distress scale (n = 3963) were analyzed by race/ethnicity. Multivariate analyses were based on the access-to-care model.


Emotionally distressed Blacks reported receiving psychological counseling significantly less than Whites and Hispanics (8% vs. 19% and 16%, respectively). The most important factors associated with receiving counseling for each racial/ethnic group were: Whites (n = 1681): suicidality and urban area, [Adjusted odds ratio (AOR) 1.9, 95th confidence interval (CI) (1.4, 2.6)] and [AOR 1.4, 95th CI, 95th CI (1.0, 1.8)], respectively; Blacks (n = 677): urban area [AOR 2.9, 95th CI (1.4, 6.0)]; Hispanics (n = 5326): suicidality and barriers to care, [AOR 2.2, 95th CI (1.0, 4.7)] and [AOR 0.4, 95th CI (0.2, 0.7)], respectively.


Predictors for receiving counseling varied for different racial and ethnic groups of adolescents. Even after adjusting for family income and parent education, distressed black adolescents were less likely to receive counseling. The findings specific to distressed black adolescents indicate that other factors may underlie differences in utilization of mental health services.

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