Intersectional disparities in access to mental health services among youth aging out of foster care

Lauren Pryce McCarthy , Yanfeng Xu , Sally Hageman , Yao Wang
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Abstract

Background

Youth aging out of the child welfare system lack support in accessing needed mental health care, as do youth of color and LGBTQ ​+ ​youth in the general population. Similar disparities may exist among youth aging out of foster care who hold intersecting social identities.

Objective

This study aimed to explore the presence of mental health care access disparities among youth aging out of foster care using an intersectional lens.

Participants

and Setting: The current study was a cross-sectional, exploratory analysis of secondary data from the Jim Casey Youth Opportunities Initiative (JCYOI) dataset. The sample included 2650 youth aging out of care.

Methods

The current study utilized bivariate tests to explore the association between access to mental health care and key variables, a rate ratio to measure access disparities, and logistic regression to determine the main effect of identity on mental health care access.

Findings

Lower rates of mental health care access were found among youth of color compared to White youth and among LGBTQ ​+ ​youth compared to non-LGBTQ ​+ ​youth. Disparities increased when youth of color also identified as LGBTQ+, however identity was not a significant predictor of mental health care access when controlling for insurance coverage and other variables.

Conclusions

Disparities in access to needed mental health care found in the general population are also present among youth aging out of foster care. These findings suggest the need for targeted efforts from practitioners to ensure equitable access to mental health care for transition aged youth.
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脱离寄养家庭的青少年在获得心理健康服务方面的交叉差异
背景脱离儿童福利系统的青少年在获得所需的心理健康护理方面缺乏支持,有色人种青少年和 LGBTQ + 青少年在一般人群中也是如此。本研究旨在从交叉性视角探讨脱离寄养家庭的青少年在获得心理健康护理方面是否存在差异:本研究是对吉姆-凯西青少年机会倡议(Jim Casey Youth Opportunities Initiative,JCYOI)数据集中的二手数据进行的一项横断面探索性分析。研究结果:与白人青年相比,有色人种青年获得心理健康护理的比率较低;与非 LGBTQ 青年相比,LGBTQ 青年获得心理健康护理的比率较高。当有色人种青少年也被认定为 LGBTQ+ 时,差距就会增大,但在控制了保险范围和其他变量后,身份并不能显著预测心理健康护理的获得情况。结论在普通人群中发现的获得所需心理健康护理方面的差距也存在于脱离寄养家庭的青少年中。这些研究结果表明,从业人员需要做出有针对性的努力,以确保过渡年龄段的青少年能够公平地获得心理保健服务。
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