Using a latent class analysis to understand mental health service needs of adolescents by service setting

Adolescents seek mental health services in various settings to address their needs. This study aims to (a) identify latent patterns of mental health service needs and (b) examine which individual and family characteristics are associated with these patterns across different service settings (school, non-school, and both). Using data from the 2019 National Survey of Drug Use and Health, we analyzed a sample of 3,210 adolescents (grades 6–12) who had received mental health services in the past 12 months. We conducted Vermunt’s 3-step Latent Class Analysis (LCA) and multinomial logistic regressions separately for three subsamples by service settings: (1) school-only (n = 585), (2) non-school-only (n = 1,810), and (3) both school and non-school (n = 815). LCA identified three distinct service need patterns across all settings: Minimal Needs, Depression-Related Needs, and Complex Needs. While these patterns were consistent across three subsamples, the composition and nature of each class varied by service setting. Adolescents with a history of major depressive episodes had significantly higher odds of being classified into the Depressive-Related Needs or Complex Needs classes. Other individual and family characteristics were differentially associated with service need patterns across settings. Findings underscore the importance of diversified service access and coordinated care to effectively address adolescent mental health needs. This study highlights the long-term implications of tailoring mental health services to better support adolescents across different service environments.