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

Adolescence is often identified as the period of time when individuals first begin to experience mental health needs, though a gap remains between need and mental health service use. With limited knowledge of continued impact of mental health service use on future services and mental health need, this study aims to examine the longitudinal, bidirectional relations between mental health service utilization and mental health symptoms across four time points. Data came from four waves of the National Longitudinal Study of Adolescent Health (Add Health; N = 7,902). We examined mental health service (MHS) utilization in the past 12 months and depressive symptoms. Cross-lagged panel analyses were conducted, adjusting for sociodemographic characteristics. Findings indicated that school MHS utilization at Tn increased the odds of using MHS at Tn+1 across all waves (OR = 1.34, 1.53, and 1.61, respectively). Second, depressive symptoms at Tn also predicted depressive symptoms at Tn+1 (β = .21, .30, .30, respectively). Third, as MHS use at Tn predicted depressive symptoms at Tn+1 (β = .14 (school), .27, .11, .18, respectively), depressive symptoms at Tn were significantly related to future mental health service use at Tn+1 (OR = 1.09, 1.15, 1.05 respectively). The current study extends the understanding of the reciprocal relationship between MHS use and depressive symptoms. The study suggests the critical importance of using school-based services in adolescence to promote mental health service use in adulthood, highlighting implications for adolescent mental health service providers across service settings.