Research Alert: April 7, 2026
New Research on Alcohol Use Disorder and Marijuana Use Disorder, Depression and Suicidal Thoughts, and Receipt of Mental Health Services Among Adolescents
This study describes the prevalence of alcohol use disorder (AUD) and marijuana use disorder (MUD) in the past year among adolescents and young adults aged 12 to 24 years in rural and urban counties and across U.S. Census Divisions in 2021.
Key Findings:
- In 2021, the prevalence of past-year AUD was 9.2% in urban and 8.5% in rural counties, and the prevalence of past-year MUD was 10.0% in both urban and rural counties among adolescents and young adults aged 12 to 24 years old.
- The prevalence of past-year MUD varied significantly across U.S. Census Divisions overall and within both urban and rural counties by Census Divisions. The prevalence of past-year MUD in rural Pacific Census Division counties was more than double the national rate (25.3%), and significantly higher than in urban (9.6%) counties of this Census Division.
This study characterizes the prevalence of behavioral health conditions among adolescents in rural and urban counties across the U.S. Specifically, this brief reports on the percentage of adolescents aged 12 to 17 reporting a major depressive episode (MDE) or suicidal thoughts and behavior in 2021.
Key Findings:
- In 2021, there was no difference in the percentage of rural vs. urban adolescents (aged 12 to 17 years) who reported having experienced a major depressive episode in the past year, but a significantly higher percentage of adolescents in rural compared to urban counties reported that they had serious suicidal ideation in the past year (18.2% vs. 14.8% with serious thoughts of suicide; 8.4% vs. 6.3% with plans of suicide).
- Nationally, the highest percentage of adolescents who reported serious suicidal ideation (23.1%), planned suicide (11.4%), or attempted suicide (7.0%) in the past year, were from rural counties with larger populations, compared to urban counties and rural counties with smaller populations.
This study characterizes the mental health services received by adolescents in rural and urban counties across the U.S. in 2021. Mental health services are defined as treatment or counseling received for emotional or behavioral problems unrelated to alcohol or drugs.
Key Findings:
- In 2021, the percentage of adolescents aged 12 to 17 years who received specialty mental health services in the past year was 18.0% in rural counties and 18.4% in urban counties.
- More than one in ten adolescents in the U.S. (10.6%), or 2.7 million, reported receiving virtual mental health services in the past year. Fewer adolescents in rural counties received virtual mental health services than urban adolescents (8.5% vs. 11.0%).
Janessa Graves, PhD, MPH
WWAMI Rural Health Research Center
Phone: 206.543.2462
janessa@uw.edu
Additional Resources of Interest:
- More FORHP-funded research on Children and adolescents, Mental and behavioral health, Substance use and treatment
- More information about the WWAMI Rural Health Research Center