Perry Nicholas S, Nelson Kimberly M
Department of Psychology, University of Denver.
Department of Community Health Sciences, Boston University School of Public Health.
Psychol Sex Orientat Gend Divers. 2024 Jun;11(2):353-360. doi: 10.1037/sgd0000592. Epub 2022 Jun 16.
Adolescent (cisgender) sexual minority males (ASMM) face multiple mental health disparities. Yet surprisingly little is known about use of mental health care among ASMM. The current study examined mental health care use among ASMM, both lifetime use and during the COVID-19 pandemic. ASMM (=154, ages 14-17 years) enrolled in Spring 2020 for a pilot randomized controlled trial of an online sexual health intervention. Participants were assessed at baseline and 3-month follow-up. Participants reported lifetime (at baseline) and recent (at follow-up) mental health care use. Anxiety and depressive symptoms were assessed at both timepoints. Differences in care use by sociodemographics, healthcare access, and mental health symptoms were established. More than half of participants reported clinically significant anxiety and depressive symptoms at baseline and at follow-up. Of those youth, fifty-three percent reported lifetime mental health care use, while only 28% reported recent care at follow-up. Being out to an accepting guardian (aOR=4.0, 95% CI: 1.9-8.4), having a primary care physician (aOR=2.6, 95% CI: 1.0-6.7), and having clinically significant symptoms (aOR=3.1, 95% CI: 1.5-6.5) were each independently associated with a greater odds of having received lifetime mental health care. Findings indicate that many ASMM in the sample received mental health care in their lifetimes. However, more participants endorsed clinically significant anxiety/depressive symptoms than received care at both timepoints. This disparity was even more pronounced approximately five months into the COVID-19 pandemic. Research and practice efforts must reduce care barriers and augment facilitators for all ASMM, with particular urgency during COVID-19 and its aftermath.
青少年（顺性别）性少数男性（ASMM）面临多种心理健康差异。然而，令人惊讶的是，对于ASMM使用心理健康服务的情况知之甚少。当前的研究调查了ASMM使用心理健康服务的情况，包括终生使用情况以及在新冠疫情期间的使用情况。2020年春季，154名年龄在14至17岁的ASMM参与了一项在线性健康干预的试点随机对照试验。在基线和3个月随访时对参与者进行评估。参与者报告了终生（基线时）和近期（随访时）使用心理健康服务的情况。在两个时间点都评估了焦虑和抑郁症状。确定了社会人口统计学、医疗保健可及性和心理健康症状在服务使用方面的差异。超过一半的参与者在基线和随访时报告有临床显著的焦虑和抑郁症状。在这些青少年中，53%报告终生使用过心理健康服务，而在随访时只有28%报告近期使用过。向接纳自己的监护人公开性取向（调整后比值比=4.0，95%置信区间：1.9 - 8.4）、有初级保健医生（调整后比值比=2.6，95%置信区间：1.0 - 6.7）以及有临床显著症状（调整后比值比=3.1，95%置信区间：1.5 - 6.5）均与接受终生心理健康服务的较高几率独立相关。研究结果表明，样本中的许多ASMM终生接受过心理健康服务。然而，认可有临床显著焦虑/抑郁症状的参与者比在两个时间点都接受服务的参与者更多。这种差异在新冠疫情大约五个月时更加明显。研究和实践工作必须减少所有ASMM的服务障碍并增加促进因素，在新冠疫情期间及其后果期间尤为紧迫。
