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Minority adolescent mental health diagnosis differences in a national sample

APA Citation:

Martin, R., Banaag, A., Riggs, D. S., & Koehlmoos, T. P. (2022). Minority adolescent mental health diagnosis differences in a national sample. Military Medicine, 187(7-8), e969-e977. https://doi.org/10.1093/milmed/usab326

Abstract Created by REACH:

Health disparities are preventable differences in the prevalence, morbidity, and survival rates of diseases based on social (dis)advantage. Comprehensive healthcare systems, such as the Military Health System (MHS), are useful for examining disparities in mental health diagnoses among adolescents. This study used a nationally representative sample of adolescents from the MHS (N = 183,409) to examine differences in diagnostic rates of depressive, anxiety, and impulse control disorders based on adolescents’ race, setting of care (i.e., military treatment facility or civilian hospital/clinic), and their active-duty parent’s rank (i.e., a proxy for household socioeconomic status [SES]). Overall, Black adolescents were more likely than White adolescents to be diagnosed with an impulse control disorder. Rates of diagnoses also varied by setting of care and parent’s military rank.

Focus:

Mental health
Youth
Children

Branch of Service:

Multiple branches
Air Force
Army
Coast Guard
Marine Corps
Navy

Military Affiliation:

Active Duty
Guard
Reserve

Subject Affiliation:

Child of a service member or veteran
Military medical service providers

Population:

Adolescence (13 - 17 yrs)
Adulthood (18 yrs & older)

Methodology:

Cross-Sectional Study
Quantitative Study
Secondary Analysis

Authors:

Martin, Raquel, Banaag, Amanda, Riggs, David S., Koehlmoos, Tracey P.

Abstract:

Mental health disparities and differences have been identified amongst all age groups, including adolescents. However, there is a lack of research regarding adolescents within the Military Health System (MHS). The MHS is a universal health care system for military personnel and their dependents. Research has indicated that the MHS removes many of the barriers that contribute to health disparities. Additional investigations with this population would greatly contribute to our understanding of disparities and health services delivery without the barrier of access to care.This study analyzed the diagnostic trends of anxiety, depression, and impulse control disorders and differences within a national sample of adolescents of active-duty military parents. The study utilized 2006 to 2014 data in the MHS Data Repository for adolescents ages 13–18. The study identified 183,409 adolescents with at least one diagnosis. Multivariable logistic regressions were conducted to assess the differences and risks for anxiety, depression, and impulse control disorders in the identified sample.When compared to White Americans, minority patients had a higher likelihood of being diagnosed with an impulse control disorder (odds ratio [OR] = 1.43; confidence interval [CI] 1.39–1.48) and a decreased likelihood of being diagnosed with a depressive disorder (OR = 0.98; CI 0.95–1.00) or anxiety disorder (OR = 0.80; CI 0.78–0.83). Further analyses examining the subgroups of minorities revealed that, when compared to White Americans, African American adolescents have a much higher likelihood of receiving a diagnosis of an impulse control disorder (OR = 1.66; CI 1.61–1.72) and a lower likelihood of receiving a diagnosis of a depressive disorder (OR = 0.93; CI 0.90–0.96) and an anxiety disorder (OR = 0.75; CI 0.72–0.77).This study provides strong support for the existence of race-based differences in adolescent mental health diagnoses. Adolescents of military families are a special population with unique experiences and stressors and would benefit from future research focusing on qualitative investigations into additional factors mental health clinicians consider when making diagnoses, as well as further exploration into understanding how best to address this special population’s mental health needs.

Publication Type:

Article
REACH Publication

Keywords:

military-connected children, youth, adolescence, military health system

View Research Summary:

REACH Publication Type:

Research Summary

REACH Newsletter:

  June 2023

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