Telemedicine disparities among adolescents with suicidal thoughts and behaviors during the COVID-19 pandemic.

Telemedicine became a vital tool during the COVID-19 pandemic, a time marked by increased social isolation and mental health challenges among adolescents. Using data from 7,998 U.S. adolescents collected in early 2021 via the Adolescent Behavior Experience Survey, this study examined intersectional disparities in telemental health use. Stratified multivariable logistic regression models revealed significantly lower odds of telemedicine use for mental health care among marginalized groups who experienced suicidal thoughts or behaviors. These included Black, Hispanic/Latino, and multi-racial Latino female adolescents; Black heterosexual adolescents; and sexual minority multi-racial non-Latino adolescents. Notably, sexual minority multi-racial non-Latino adolescents showed higher odds of telemental health care use in some cases. The findings highlight critical gaps in access and underscore the need for targeted strategies to improve equitable mental health service delivery, particularly for racially diverse sexual and gender minority youth navigating intersecting structural and identity-based inequities.