Access to Adolescent Mental Health Care

As symptoms of mental health disorders emerge and develop, they have strong influences on an adolescent’s behavior and can become more difficult to treat. Although effective therapies exist for many mental health disorders, not all adolescents who need treatment receive it.1 The following disparities may partially explain why use of mental health services differs by age, race/ethnicity, income, and other characteristics:

  • Twenty-one percent of youth ages 6 to 17 who live in poverty have mental health disorders.2
  • Youth in the juvenile justice system experience significantly higher rates of mental health and substance use disorders compared to their peers.3
  • Female adolescents are more likely than male adolescents to receive mental health services.2
  • Asian adolescents are less likely than adolescents of most other races/ethnicities to receive mental health services.2
  • White youth are more likely to receive mental health services compared to youth of color.1

Mental Health and Health Care Legislation

The Mental Health Parity and Addiction Equity Act, the Affordable Care Act, and the Medicaid expansion in many states have helped improve access to mental health services for Americans of all ages:4

  • The Mental Health Parity and Addiction Equity Act (MHPAEA) requires that insurers cover and reimburse services for mental health and substance use disorders as they would other physical health services. However, MHPAEA does not require health insurance plans to include mental health or substance use disorders benefits; its requirements apply only to insurers that include mental health or substance use disorders in their existing benefit packages.
  • The Affordable Care Act (ACA) requires that most individual and small-employer health insurance plans—including all plans offered through the Health Insurance Marketplace—cover mental health and substance use disorders services. Additionally, under the ACA, most health plans must cover preventive services (e.g., depression screening for adults and behavioral assessments for children) at no additional cost.
  • Medicaid expansion includes benefits for people with mental health and substance use disorders, and states that coverage must meet the same parity requirements required under MHPAEA for other health plans.
  • The Children's Health Insurance Program also is required to comply with mental health and substance use disorder parity requirements.

Footnotes

1 Substance Abuse and Mental Health Services Administration. (2024). Behavioral health by race and ethnicity: Results from the 2021-2023 National Surveys on Drug Use and Health. U.S. Department of Health and Human Services. https://www.samhsa.gov/data/report/2021-2023-nsduh-behavioral-health-race-ethnicity back to top

2 Lipari, R. N., Hedden, S., Blau, G., & Rubenstein, L. (2016). The CBHSQ report: Adolescent mental health service use and reasons for using services in specialty, educational, and general medical settings. Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/adolescent-mental-health-service-use-and-reasons-using-services-specialty-educational-and back to top

3 Office of Juvenile Justice and Delinquency Prevention. (2025, September). How the juvenile justice system addresses youths’ mental health. Model Programs Guide. https://ojjdp.ojp.gov/model-programs-guide/literature-reviews/how-the-juvenile-justice-system-addresses-youths-mental-health back to top

4 Frank, R. G., Beronio, K, & Glied, S. A. (2014). Behavioral health parity and the Affordable Care Act. Journal of Social Work in Disability & Rehabilitation, 13(0), 31–43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4334111/ back to top