Adverse Childhood Experiences, Mental Health, and Access to Treatment: Differences Among Rural and Urban Youth

Adverse childhood experiences (ACEs) are associated with poor adolescent mental health. Despite evidence that ACEs may be more prevalent in rural communities, it remains underexplored how region moderates the association between ACEs and mental health, as well as how access to treatment may vary across regions. Data for this study come from the 2019 Minnesota Student Survey, a state-wide survey of 125,375 adolescents. Results suggest that cumulative ACEs and certain mental health conditions (i.e. suicidality) were more common among town and rural youth compared to city and suburban youth. Even after adjusting for ACEs, town and rural youth who endorsed a mental health problem were less likely to receive treatment compared to urban peers. The findings have implications for social work and public health responses that reduce ACEs, particularly in rural communities, and expand treatment options for adolescent mental health in more remote settings.