Reported Receipt of Mental Health Services by Adolescents Aged 12 to 17 in the Rural and Urban U.S., 2021

This study characterizes the mental health services received by adolescents in rural and urban counties across the United States in 2021. Mental health services are defined as treatment or counseling received for emotional or behavioral problems unrelated to alcohol or drugs. Specifically, this brief estimates the percentage of adolescents aged 12 to 17 years who report having received the following services in the past year: specialty mental health services in inpatient and/or outpatient settings, treatment from a therapist or counselor, non-specialty mental health services, mental health services in a general medical setting, and virtual mental health services.

Key Findings:

• In 2021, 18.0% of adolescents aged 12 to 17 years in rural counties and 18.4% in urban counties received specialty mental health services in the past year (for emotional or behavioral problems unrelated to alcohol or drugs).
• Approximately one in six (15.7%) adolescents aged 12 to 17 years reported receiving specialty outpatient mental health services from a private therapist, psychologist, psychiatrist, social worker, or counselor in an outpatient setting that is not part of a clinic in the past year, with slightly fewer rural adolescents (14.5%) receiving these services than urban adolescents (15.9%).
• Receiving inpatient specialty mental health services was uncommon, with 2.5% of adolescents aged 12 to 17 years reporting this type of mental health care in the past year. The percentage of adolescents who received inpatient specialty mental health services in inpatient treatment settings did not vary significantly by rurality (urban 2.4%, rural 2.8%) or Census Division.
• A total of 15.4% of adolescents aged 12 to 17 years in rural counties and 14.5% in urban counties received non-specialty mental health services in a non-specialty setting in the past year, such as those delivered in education, general medicine, juvenile justice, or child welfare settings.
• In 2021, more than one in ten adolescents aged 12 to 17 years 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%).