Some new findings about disparities in the way young adults of different races use mental health services have been troubling me since I first read about them last week.
Whites who received “psychological or emotional counseling” as teenagers were more likely to be in treatment as young adults compared to their age peers who didn’t receive counseling, a study in Psychological Services found.
But for black young adults, the findings were reversed: Having received counseling as teens made them less likely to receive services as adults.
The findings come from the National Longitudinal Study of Adolescent Health, which first interviewed teens in grades 7-12 back in 1995 and followed up again in 1996 and then in 2001, when the subjects were young adults.
A weakness in the study is that it defined “counseling” very loosely – it could mean anything from talking to a guidance counselor to receiving advice from a priest to going to five-times-a-week psychoanalysis.
But the basic message is still vexing. It suggests that, at least during the 1990s, black teenagers were receiving care that soured them on mental health treatment later on.
Adults sometimes think that simply getting kids some help – any help – is good enough. But this study seems to suggest that unpleasant early treatment experiences can keep kids from getting care they need in young adulthood.
It doesn’t tell us what, exactly, is so off-putting about the treatment these black adolescents received. But it does suggest the importance of tailoring mental health treatment to make it more palatable to kids. What works for one ethnic group, or even one person, doesn’t always work for another.
At first glance, it might seem that this doesn’t apply to medication, which seems wonderfully anonymous, working the same no matter how old you are, what ethnic group you come from, or what socioeconomic group you belong to. But, as I’ve argued in previous blog posts, and as I argue in my forthcoming book, context matters, a lot.
Kids develop all kinds of associations around medication, and they remember them, just as they remember the kinds of experiences they have with counseling. These early encounters determine whether or not they decide to continue or re-start treatment as young adults.
Sometimes, young people may not need to continue treatment past childhood or adolescence. But to have poorly-delivered counseling or pharmaceutical treatment prevent them from getting care that they genuinely need is a slap in the face for those who advocate early intervention.