Mental Health Service Engagement Among Underserved Minority Adolescents and Young Adults: a Systematic Review

Limited ability to engage underserved racial-ethnic minority young adults into treatment contributes to mental health disparities among this population. A systematic literature review was conducted to examine the evidence for interventions that can improve their engagement with mental health services. A database search and bibliographic review yielded 1264 studies that were assessed according to the following inclusion criteria: sample with a mean age between 13 and 27; sufficient ethnic/racial representation (at least 50%); an explicitly stated objective for the intervention of improving mental health treatment engagement among adolescents and young adults (e.g., initiating treatment, retention, completion); and evaluation of an engagement outcome, such as session attendance or service utilization. Ten studies met inclusion criteria. Studies varied according to level of evidence for efficacy with underserved young adults, with four meeting criteria as probably efficacious. Interventions that were family based or were culturally adapted for age group or race-ethnicity also showed possible efficacy and promising results. Although the lack of studies focused on this population limited findings, evidence supports incorporating family and natural supports in a developmentally appropriate way, facilitating independence, and attending to cultural context as key components of interventions designed to address the unmet need in underserved minority young adults.