Objective: To examine differences in lifetime prevalence of mental disorder and service use among U.S. adolescents by both immigrant generation and race/ethnicity. Method: A total of 6,250 adolescents aged 13 to 18 years in the National Comorbidity Survey Replication Adolescent Supplement were assessed for lifetime prevalence of mood and/or anxiety disorders, behavior disorders, and mental health service use. Twelve groups defined by self-identified race/ethnicity (non-Hispanic white, Hispanic, non-Hispanic black, Asian) and immigrant generation (first, second, third, or more) were compared. Results: Differences in prevalence of lifetime mental disorder were most apparent when immigrant generation and race/ethnicity were considered jointly. Compared to third+generation non-Hispanic white adolescents, the odds of mood/anxiety disorder were increased among second-generation Asian (adjusted odds ratio [AOR] = 2.51; 95% CI = 1.22−5.17) and third+generation Hispanic (AOR = 1.28; 95% CI = 1.00−1.63) but reduced among first-generation Asian (AOR = 0.27; 95% CI = 0.10−0.71) and second-generation non-Hispanic white adolescents (AOR = 0.50; 95% CI = 0.30−0.81). The odds of behavior disorder were lower among first-generation Asian (AOR = 0.26; 95% CI = 0.09−0.71) and all generations of non-Hispanic black adolescents (AOR range 0.43−0.55). Adjusting for lifetime disorder, first-generation Hispanic and non-Hispanic white adolescents and all generations of non-Hispanic black adolescents were less likely to receive mental health services (AOR range 0.24−0.55). Conclusions: Variation in risk of disorder by immigrant generation and race/ethnicity underscores the importance of considering social, economic, and cultural influences in etiologic and treatment studies of adolescent psychopathology. Lower rates of service use, particularly among first-generation immigrant adolescents, highlight the need to identify and address barriers to recognition and treatment of mental disorders among adolescents from immigrant and racial/ethnic minority backgrounds. © 2018

mental health services Ethnicity Mental disorder race mental health disparities Immigration

mood disorder immigrant Asian anxiety disorder mental health service Caucasian race difference human controlled study priority journal Mental Health Services ethnology mental disease United States Humans migrant Hispanic Adolescent Black person male Emigrants and Immigrants female prevalence Article behavior disorder health care utilization major clinical study adult patient attitude Patient Acceptance of Health Care Mood Disorders