Patterns of psychological distress, substance use, and marginalized identity intersect to shape adolescents' access to mental health care, with sexual orientation moderating associations between mental health risk profiles, perceived barriers, and help-seeking intentions.
Latent Profile Analysis identified four distinct mental health profiles among Israeli adolescents.
Barriers to mental health care clustered into three distinct domains identified through Exploratory Graph Analysis.
Higher-risk mental health profiles were associated with greater perceived barriers to care and lower intentions to seek help.
Sexual orientation moderated the association between mental health profile membership and help-seeking intentions in different directions depending on the substance use profile.
Sexual minority adolescents represented 30% of the study sample, a notable proportion reflecting the study's intentional inclusion of this population.
This research suggests that Israeli teenagers experience distinct patterns of mental health challenges that can be grouped into four categories: those who are relatively well, those experiencing emotional difficulties and thoughts of suicide, those who use tobacco and e-cigarettes, and those who use cannabis. Researchers also found that the obstacles teenagers face when trying to get mental health help fall into three types: barriers related to their identity, practical barriers like cost or availability, and internal emotional barriers like embarrassment or fear. Teenagers in the more at-risk groups reported more of these barriers and less willingness to seek help. This research suggests that being a sexual minority (such as identifying as gay, lesbian, bisexual, or another non-heterosexual identity) meaningfully changes how these patterns play out. Sexual minority teens who used tobacco and e-cigarettes were even less likely to want to seek help than their heterosexual peers in the same group, while sexual minority cannabis users were actually more likely to express intentions to seek help. This points to complex and sometimes unexpected ways that identity intersects with mental health and help-seeking behavior. The practical implication of these findings is that one-size-fits-all approaches to adolescent mental health outreach are likely insufficient. This research suggests that programs designed to connect teenagers with mental health support need to be tailored to specific risk profiles and be sensitive to identity-related concerns, particularly for sexual minority youth who face unique barriers to care. Reducing structural obstacles (like cost and access) and creating affirming, non-judgmental environments may be especially important for reaching the teenagers who need support most.
Gewirtz-Meydan A, Berkowitz R, Maoz S, Shilo G, Neumark Y. (2026). Latent profiles of mental health and care barriers among heterosexual and sexual minority adolescents.. Israel journal of health policy research. https://doi.org/10.1186/s13584-026-00781-0