Exposure to Community Violence, Use of Mental Health Services and Depressive Symptoms Among Adolescents and Young Adults

Objectives

Understand the long-term connection between victimization in the community and an individual’s report of depressive symptoms

Discuss the use of mental health services among individuals after childhood victimization in the community

Discuss the role of mental health service use in attenuating the short- and long-term negative psychological influences from these early adverse life experiences

Abstract

Background: Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. Objective: This study assesses 1) If subtypes of adolescent victimization are linked to depressive symptoms; 2) If adolescent victimization is linked with mental health service use; and 3) The role of mental health service use in attenuating symptoms arising from victimization. Methods: This study focused on data from 8,947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health. Results: Findings indicate adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health services mediates report of depressive symptoms for adolescents witnessing community violence. Conclusion: This study describes the interplay among risk, psychosocial processes and treatment utilization in the manifestation of depressive symptoms in persons exposed to violence in adolescence. Further, our finding that direct exposure to violence during adolescence does not predict adolescent depressive symptoms but does for adult depressive symptoms points toward a more complex etiological process whereby a cascade of risk may be activated by violence exposure that is not measurable until adulthood. These results show the need for gateways that enable adults to access mental health services and for comparable or unique strategies for adolescents.