Unmet Mental Health Needs and Academic Outcomes Among First-Generation U.S. Youth

Background and Purpose: First-generation youth in the United States often navigate cultural and structural stressors that shape both their mental health and educational experiences. Mental health challenges, including unmet needs for care, may have important implications for academic outcomes. This study examines the association between mental health status and academic outcomes among first-generation youth and explores patterns of academic performance in relation to immigrant status.

Methods: Data were used from the 2022 National Survey of Children’s Health (N = 36,542), a nationally representative sample of U.S. children. Independent variables included mental health treatment status (received treatment, unmet need, no identified need) and diagnosis of anxiety or depression. Academic outcomes included poor grades and grade repetition based on parent report. Immigration status was measured using parental nativity (immigrant vs. non-immigrant households). Multivariate logistic regression models were used to estimate associations, controlling for key sociodemographic covariates.

Results: Mental health was significantly associated with academic outcomes among youth. Youth with unmet mental health care needs had the highest odds of poor academic outcomes, including poor grades (OR = 3.94, 95% CI: 3.26, 4.75) and grade repetition (OR = 1.48, 95% CI: 1.18 - 1.86) compared to youth with no reported mental health care needs. Youth receiving treatment also had elevated odds of poor grades (OR = 2.91, 95% CI: 2.54, 3.33) and grade repetition (OR = 1.29, 95% CI: 1.11, 1.49), suggesting persistent academic challenges. Youth diagnosed with anxiety or depression had increased odds of poor grades (OR = 1.96, 95% CI: 1.71, 2.22) and grade repetition (OR = 1.47, 95% CI: 1.27, 1.69) compared to children not diagnosed. In contrast, youth from immigrant families had lower odds of poor grades (OR = 0.76, 95% CI: 0.63, 0.89) and grade repetition (OR = 0.79, 95% CI: 0.66, 0.93) compared to non-immigrant families, indicating patterns of academic resilience.

Conclusions and Implications: Mental health challenges, particularly unmet mental health needs, are strongly associated with poorer academic outcomes among youth, while first-generation youth demonstrate relative academic resilience. These findings highlight the importance of addressing both access to mental health care and the broader structural factors that shape educational outcomes. Social workers play a critical role in expanding access to school-based mental health services, supporting early identification and intervention, and advocating for policies that reduce barriers to care and promote equitable educational opportunities.