Examining Longitudinal, Reciprocal Relations Between Mental Health Service Use and Mental Health Symptoms

Area of Science:

• Adolescent mental health
• Longitudinal studies
• Public health

Background:

• Adolescence is a critical period for mental health needs emergence.
• A significant gap exists between adolescent mental health needs and service utilization.
• Longitudinal impacts of mental health service use on future needs are understudied.

Purpose of the Study:

• To investigate the longitudinal, bidirectional relationship between mental health service utilization and depressive symptoms in adolescents.
• To understand how past service use and symptoms predict future outcomes.
• To inform adolescent mental health service strategies.

Main Methods:

• Utilized data from four waves of the National Longitudinal Study of Adolescent Health (Add Health; N = 7,902).
• Employed cross-lagged panel analyses to examine mental health service (MHS) utilization and depressive symptoms.
• Adjusted analyses for sociodemographic characteristics.

Main Results:

• School MHS utilization at one time point predicted increased MHS use at the next (ORs = 1.34-1.61).
• Depressive symptoms at one time point predicted future depressive symptoms (βs = .21-.30).
• MHS use predicted reduced future depressive symptoms (βs = .14-.27), and depressive symptoms predicted future MHS use (ORs = 1.05-1.15).

Conclusions:

• A reciprocal relationship exists between adolescent mental health service use and depressive symptoms.
• School-based mental health services are vital for promoting sustained service use into adulthood.
• Early and consistent MHS engagement is key for adolescent mental health trajectories.