Behavioral Health among Foreign-Born and U.S.-Born Emerging Adults: Barriers to Seeking Services, College Enrollment Status, and Service Utilization

Behavioral health problems are a leading cause of disability and a major public health issue in the United States. Compared to other adult age groups, emerging adults aged 18 to 29 experience more behavioral health problems. Although transitioning to adulthood may provide growth opportunities, it can also be a time of increased vulnerability and risk as emerging adults often face challenges in emotional, educational, and professional transitions. The United States has also seen rapid growth in the foreign-born emerging adult population as well as growing health disparities among immigrant and minority groups; however, prior research investigating behavioral health service use of emerging adults has largely been limited to homogeneous samples of college students. Using the Behavioral Model for Vulnerable Populations, this study explored factors associated with patterns of behavioral health service use across a diverse national sample of emerging adults by nativity status (foreign-born, U.S.-born) and college enrollment status (college student, non- student). A subsample of 6,696 emerging adults from the 2012 Agency for Healthcare Research and Quality Medical Expansion Panel Study was used for this study. Multiple hierarchical binomial logistic regression analyses were performed to determine which factors predicted patterns of behavioral health service use among emerging adult groups. Employed (foreign-born) and Black (all groups except foreign-born) emerging adults were less likely to use services compared to unemployed and White emerging adults, respectively. Preference for English language (non-college students), shorter duration in the United States (college students), and having insurance (all groups except foreign-born) was associated with service use. Those with middle and high income backgrounds (college students) were less likely to use services compared to poor students. Having higher perceived mental health status (all groups except college students) and higher general mental health status (all groups) predicted less service use. Although certain factors were consistently predictive of service use among emerging adult groups, there were differences that necessitate further research. Findings clearly portray the need for greater awareness and consideration of factors related to service use on healthcare policy and higher education program initiatives especially as they relate to promoting health equity and successful transition to adulthood.