Abstract
OBJECTIVE: Previous work has highlighted associations between Adverse Childhood Experiences (ACEs) and mental health care use, but few studies use nationally representative data self-reported by teenagers. METHODS: Data came from the cross-sectional National Health Interview Survey (NHIS)- Teen (July 2021-December 2023), an online follow-back survey of teenagers whose parents answered the child portion of the main NHIS. Multivariate logistic regression models estimated associations between selected ACEs and a summed ACEs score (four or more ACEs vs. three or less), and mental health care use in the past 12 months: 1) took prescription medication, 2) received therapy, and 3) unmet mental health care need due to 4) cost, 5) stigma, and 6) not knowing where to go, among teenagers aged 12-17 (N = 1677). RESULTS: One-tenth of teenagers (11.5%) had four or more selected ACEs. Around 15.2% of teenagers took prescription medication for their mental health in the past 12 months, while 18.7% received therapy. Having four or more ACEs (adjusted prevalence ratio, APR: 1.43, 95% confidence interval, CI: 1.02-2.01), being a victim or witnessing violence in the neighborhood (APR: 1.41, 95% CI: 1.06-1.88), experiencing emotional abuse (APR: 1.50, 95% CI: 1.12-2.02), and experiencing racism (APR: 1.46, 95% CI: 1.10-1.94) were related to taking prescription medication. Most selected ACEs were related to higher prevalence of receiving therapy (eg, household mental illness, APR:1.97; 95% CI: 1.50-2.58). CONCLUSIONS: ACEs were related to greater use of mental health care and selected barriers for unmet mental health care need. Future work may examine the underlying mechanisms of these associations.