4 - (SYM 13) Neighborhood Resources, Discrimination, and Treatment Access for Adolescents Engaging in Self-injury

Background. Past research has suggested that both structural and discrimination-related barriers may undermine access to mental health treatment among adolescents experiencing self-injurious thoughts and behaviors. However, their relative impacts on treatment access is unclear. Accordingly, we investigated the relationship between identity-based discrimination, neighborhood resources, and access to two levels of mental health treatment: outpatient and self-help.

Method. Our sample of N = 515 13 to 16-year-old adolescents, drawn from an online intervention trial (NCT04498143), indicated a history of self-injurious behaviors and identified with diverse racial/ethnic identities (5.82% Native American, 6.99% Asian, 10.29% Black/African American, 21.74% Hispanic/Latinx, 1.74% Native Hawaiian or Pacific Islander, 74.36% White) and gender identities (37.47% gender minority youth). We conducted logistic regressions to gauge the relationship between 1) identity-based discrimination and mental health treatment access and 2) 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.

Results. For outpatient treatment only, we found that greater neighborhood resources were associated with increased odds of treatment access (OR = 1.51, p < .001). Perceived discrimination showed no relationship to treatment access of any kind.

Conclusion. Results support the presence of a link between neighborhood resources and access to outpatient treatment in self-injurious adolescents. Structural factors play an important role in treatment access for adolescents experiencing self-injurious thoughts and behaviors.