Publication date: Jun 12, 2025

Young adulthood is a critical time for understanding mental health needs and young adults experience adverse symptoms at alarmingly increased rates. Following COVID-19, telehealth services came to the forefront of care for all ages. Despite increased use of telehealth services for behavioral health needs, a gap remains between service need and service use among young adults. Informed by Andersen’s Behavioral Model of Health Care Utilization, the current study examined theoretically related factors for telehealth service utilization among young adults. Data were from the 2021 National Survey of Drug Use and Health. Participants were ages 18 to 25 years old (N = 13,979). Predictors included predisposing factors (sociodemographic characteristics), enabling factors (income, geographic location, insurance, and government assistance), and need factors (health, mental health, and substance use). A forward selection logistic regression was used to determine their impact on past-year telehealth use. Findings revealed factors associated with increased likelihood of telehealth use, including being female, being older, enrolled in school, being employed, earning over $75,000 per year, living in a metropolitan area, and having mental health, substance use, or health concerns. In contrast, identifying as non-white, being unemployed, earning between $20 k-$74 k, being on government assistance, or having insurance were associated with a decreased likelihood of telehealth use. Findings reveal important disparities and highlight the ongoing need to address structural and systemic barriers in telehealth access. Implications for practice and policy include expanding digital access, ensuring insurance flexibility that supports telehealth services, and investing in culturally responsive care models and training.

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