Neighborhood Resources, Discrimination, and Mental Health Treatment Access for Youth Engaging in Self-Injury

Past research has suggested that structural and discrimination-related barriers might undermine access to mental health treatment in youth experiencing self-injurious thoughts and behaviors, but their relative impacts on treatment access is unclear. Accordingly, we investigated associations between everyday discrimination, neighborhood resources, and access to two levels of mental health treatment: outpatient and self-help. Our sample of N = 516 13 to 16-year-old youth, drawn from a previously recruited online intervention trial (NCT04498143), indicated a history of self-injurious behaviors and identified with diverse racial/ethnic identities (5.81% Native American, 6.98% Asian, 10.27% Black/African American, 21.71% Hispanic/Latinx, 1.74% Native Hawaiian or Pacific Islander, 74.42% White) and gender identities (37.40% gender minority youth). We conducted logistic regressions to gauge associations between (a) everyday discrimination and mental health treatment access and (b) neighborhood resources and mental health treatment access. Predictors were the Everyday Discrimination Scale (EDS), to assess discrimination experiences, and the Child Opportunity Index (COI), to assess for neighborhood resources. For outpatient treatment only, we found that greater neighborhood resources were associated with increased odds of treatment access (OR = 1.49, p < .001). Everyday discrimination showed no association to treatment access of any kind. Results support the presence of a link between neighborhood resources and access to outpatient treatment in youth with recent history of self-injury.