@article{ref1,
title="Family structure and adolescent mental health service utilization during the COVID-19 pandemic",
journal="Journal of Adolescent Health",
year="2023",
author="Burrell, Tierra D. and Kim, Seohyun and Mohadikar, Karishma and Jonas, Cabell and Ortiz, Nancy and Horberg, Michael A.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="PURPOSE: This study evaluated the relationship between sociodemographic factors including family structure and mental health service (MHS) utilization before and during the COVID-19 pandemic. We also investigated the moderation effects of the COVID-19 pandemic on MHS utilization. <br><br>METHODS: Our retrospective cohort study analyzed adolescents aged 12-17 years with a mental health diagnosis as identified in the electronic medical record enrolled in Kaiser Permanente Mid-Atlantic States in Maryland and Virginia, a comprehensive integrated health system. We used logistic regression models with an interaction term for the COVID-19 pandemic year to determine the relationship between family structure and adolescent MHS utilization ≥ one outpatient behavioral health visit within the measurement year, while adjusting for age, chronic medical condition (= physical illness lasting > 12 months), mental health condition, race, sex, and state of residence. <br><br>RESULTS: Among 5,420 adolescents, only those in two-parent households significantly increased MHS utilization during COVID-19 compared to the prepandemic year (McNemar's χ(2) = 9.24, p < .01); however, family structure was not a significant predictor. Overall, the odds of adolescents using MHS were associated with a 12% increase during COVID-19 (odds ratio 1.12, 95% confidence interval [CI]: 1.02-1.22, p <.01). Higher odds of using MHS was associated with chronic medical condition (adjusted odds ratio = 1.15; 95% CI: 1.05-1.26, p <.01) and with White adolescents compared to all racial/ethnic minorities. The odds ratio of females using MHS compared to their male counterparts increased by 63% (ratio of adjusted odds ratio = 1.63; 95% CI: 1.39-1.91, p <.01) during the COVID-19 pandemic. <br><br>DISCUSSION: Individual-level demographic factors served as predictors of MHS utilization with effects moderated by COVID-19.<p /> <p>Language: en</p>",
language="en",
issn="1054-139X",
doi="10.1016/j.jadohealth.2023.01.018",
url="http://dx.doi.org/10.1016/j.jadohealth.2023.01.018"
}