Mental Health America (MHA) recently partnered with the Data Equity Coalition to release a data brief focused on youth mental health. This brief is part of a series advocating for standardized data …
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Mental Health America (MHA) recently partnered with the Data Equity Coalition to release a data brief focused on youth mental health. This brief is part of a series advocating for standardized data collection methods regarding race, ethnicity, language (REL), sexual orientation, gender identity (SOGI) and disability status.
MHA is advocating for standardized data collection methods recommended to the Office of Management and Budget (OMB) to improve mental health outcomes for underserved youth.
The OMB, overseeing federal agency operations, issues policies like Statistical Policy Directive (SPD) No. 15, established during the Civil Rights Movement, to standardize data collection on race and ethnicity, ensuring consistency for better data evaluation.
Despite revisions in 1997 and 2024 to accommodate increasing diversity, MHA is urging OMB to extend standards to include language, sexual orientation, gender identity and disability status. Health disparities, including mental health conditions, are influenced by factors such as race, ethnicity, economic status and language, aligning with federal laws like the Rehabilitation Act of 1973 and the Affordable Care Act.
Collecting consistent data nationwide is crucial for evaluating and implementing changes to address health disparities and promote mental health equity. Standardized data can help identify underserved groups and inform targeted solutions by insurers, healthcare providers, employers and patient advocates.
Equity in mental health is crucial for overall well-being, as mental and physical health are intertwined. Poor mental health increases the risk of chronic conditions like diabetes and heart disease, while physical health conditions can elevate the risk of mental illness. Mental health equity addresses how certain populations face disparities in identifying, treating, and recovering from mental health conditions due to structural factors beyond their control.
Marginalized racial and ethnic communities, as well as LGBTQ+ communities, experience significant barriers to accessing mental health care, including shortages in the behavioral health workforce and limitations in insurance coverage. The Satcher Health Leadership Institute highlights the need for policymakers to invest in infrastructure and a specialized workforce to address these disparities, calling for standardized measurements of race, ethnicity, language, sexual orientation, gender identity and disability status to better assess and address the needs of underserved populations.
Mental health issues among young people have become increasingly prevalent, with challenges such as depression and suicide rates on the rise. Over the past decade, the percentage of youth aged 12-17 experiencing major depressive episodes nearly doubled, while the national suicide rate among those aged 10-24 increased by over 50%. Despite a brief decrease in suicide rates in 2019 and 2020, they rebounded to near-peak levels in 2018.
The COVID-19 pandemic exacerbated these issues, with studies indicating a rise in symptoms like persistent sadness, suicidal thoughts and anxiety among youth. According to SAMHSA's NSDUH, a significant portion of youth with suicidal thoughts attributed them to the pandemic. However, existing systems have yet to adequately adapt to meet the mental health needs of young people, particularly those from historically marginalized and under-resourced communities. Standardized data collection is essential for accurately understanding these needs and improving support systems.
The U.S. is undergoing increasing racial and ethnic diversity, with less than half of Generation Alpha identifying as non-Hispanic white. To grasp current trends in mental health needs, access barriers, and disparities among youth, disaggregation of mental health data by race and ethnicity is crucial.
For instance, while overall youth experiencing major depressive episodes (MDE) increased by 7.6% from 2009-2019, Hispanic or Latino youth saw a 2.6% higher increase than non-Hispanic youth. Disaggregated data also sheds light on COVID-19's impact, revealing different trends in suicidal ideation among ethnic groups. Failure to disaggregate data can mask significant disparities, such as the disparity in access to care between Black and white youth, where fewer Black youth receive treatment despite improvements overall.
Disaggregated analyses further expose widening disparities among underserved populations, highlighting the urgent need for consistent disaggregation of youth mental health data.
Disparities in youth mental health by sexual orientation and gender identity
The recent update of OMB SPD No. 15 lacks specific standards for collecting sexual orientation and gender identity data, hindering our comprehension of mental health needs among LGBTQ+ youth. Existing mental health datasets from federal agencies often lack a "nonbinary" gender option and present inconsistent categories for sexual orientation, impeding researchers and advocates in tracking trends in LGBTQ+ youth mental health across agencies.
CDC's YRBS survey indicates significantly higher rates of mental health challenges among LGBTQ+ youth, with 45% of LGBQ+ high school students seriously considering suicide compared to 15% of heterosexual students in 2021. Mental Health America's Online Screening and Prevention Program data further highlights disparities, showing that LGBTQ+ youth, especially transgender and nonbinary individuals, are more likely to score at risk for mental health conditions and experience frequent suicidal ideation compared to their non-LGBTQ+ peers. Among transgender youth, 65% reported frequent suicidal ideation, with the highest rates observed among transgender boys.
As LGBTQ+ youth identification continues to rise, updating OMB SPD No. 15 to standardize sexual orientation and gender identity data is crucial for understanding mental health needs and developing targeted interventions and supports for LGBTQ+ youth and their families.
The lack of standardized definitions for mental health disability in data collection poses challenges for planning equitable resource allocation and support distribution for children and families. The Office of Population Affairs at the U.S. Department of Health and Human Services considers measures of mental, emotional, developmental or behavioral problems from the National Survey of Children's Health (NSCH) as indicators of disability among youth.
From 2020-2021, 23% of children aged 3-17 had a mental, emotional, developmental or behavioral (MEDB) problem, with those identified as "Other non-Hispanic" having the highest rates at 27%. Additionally, 64% of parents of children with MEDB problems reported their child's health conditions affecting daily activities. Obtaining necessary mental health treatment or counseling was reported as somewhat or very difficult by 47% of parents, and 5% reported it as not possible.
The American Community Survey (ACS) by the U.S. Census Bureau also includes measures of disability, with cognitive disability being the most common type among children aged 5-17 in 2019 at 4.4%. Furthermore, the U.S. Department of Education measures youth mental health disability under the Individuals with Disabilities Education Act (IDEA), identifying 5.45% of students with emotional disturbance in the 2018-2019 school year. However, this measure may not fully capture the breadth of youth mental health disability, as rates of challenges increased while identification decreased over a decade.
Standardized and consistent measures are crucial to understanding mental health disability prevalence, especially by race, ethnicity and intersectional identities, aiding stakeholders in equitable resource allocation and support for underserved children and families.
