Impact of Neighborhood Disadvantage on Youth Emotional Symptoms and Transdiagnostic Cognitive-Behavioral Treatment Outcomes.

Youth living in low-resource geographical areas may have a greater need for and/or poorer access to mental health care. Neighborhood disadvantage is associated with a range of adverse mental health symptoms for adults, but relatively fewer studies have examined the impacts of neighborhood disadvantage on mental health symptoms in youth. This study used the Area Deprivation Index to examine neighborhood disadvantage among a large sample of youth seeking (N = 935) and receiving (n = 544) transdiagnostic cognitive-behavioral treatment using the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents at a university-based research clinic in the southeastern United States. Neighborhood disadvantage did not impact rates of treatment enrollment but was associated with older youth age at the time of treatment enrollment and greater clinician- and caregiver-reported (although not youth self-reported) emotional symptom severity at pre-treatment. Neighborhood disadvantage was not associated with attendance or response to the transdiagnostic cognitive-behavioral treatment. Together, findings suggest that neighborhood disadvantage may have a greater impact on delays in accessing specialty care than on the benefits of such care once it is initiated. Delays in treatment access may lead to an exacerbation of youth emotional symptoms in the period prior to treatment initiation. Findings can inform future efforts to leverage community-integrated recruitment approaches to better understand and address barriers to care for youth from disadvantaged neighborhoods for the goal of improving youth mental health outcomes.