Selected Teen-Reported Adverse Childhood Experiences (ACEs) and Mental Health Care Use.

OBJECTIVE

Previous work has highlighted associations between Adverse Childhood Experiences (ACEs) and mental health care use, but few studies use nationally representative data self-reported by teenagers.

METHODS

Data came from the cross-sectional National Health Interview Survey (NHIS)- Teen (July 2021-December 2023), an online follow-back survey of teenagers whose parents answered the child portion of the main NHIS. Multivariate logistic regression models estimated associations between selected ACEs and a summed ACEs score (four or more ACEs vs. three or less), and mental health care use in the past 12 months: 1) took prescription medication, 2) received therapy, and 3) unmet mental health care need due to 4) cost, 5) stigma, and 6) not knowing where to go, among teenagers aged 12-17 (N = 1677).

RESULTS

One-tenth of teenagers (11.5%) had four or more selected ACEs. Around 15.2% of teenagers took prescription medication for their mental health in the past 12 months, while 18.7% received therapy. Having four or more ACEs (adjusted prevalence ratio, APR: 1.43, 95% confidence interval, CI: 1.02-2.01), being a victim or witnessing violence in the neighborhood (APR: 1.41, 95% CI: 1.06-1.88), experiencing emotional abuse (APR: 1.50, 95% CI: 1.12-2.02), and experiencing racism (APR: 1.46, 95% CI: 1.10-1.94) were related to taking prescription medication. Most selected ACEs were related to higher prevalence of receiving therapy (eg, household mental illness, APR:1.97; 95% CI: 1.50-2.58).

CONCLUSIONS

ACEs were related to greater use of mental health care and selected barriers for unmet mental health care need. Future work may examine the underlying mechanisms of these associations.