More Than Hurt Feelings: Associations Between Perceived Racial Discrimination and Mental Health, Substance Use, and Victimization Among Racial and Ethnic Minority Adolescents.

BACKGROUND: Although prior research has linked perceived racial discrimination (PRD) to adverse outcomes among adolescents, fewer studies have comprehensively examined its associations with mental health, substance use, and victimization outcomes within a single nationally representative sample. The objective of this study is to examine the associations between school-based interpersonal PRD and a broad range of mental health, substance use, and victimization outcomes among racial/ethnic minority adolescents in the United States. METHODS: Data for this study were obtained from the 2023 Youth Risk Behavior Survey. The analytic sample included 9,885 racial/ethnic minority adolescents aged 14-18 (50.7% male). The associations between school-based interpersonal PRD and twenty-two outcomes spanning mental health (n = 6), current substance use (n = 6), and victimization and violence-related experiences (n = 10) were examined using binary logistic regression. RESULTS: We found that 16.7% of adolescents reported sometimes experiencing school-based interpersonal PRD and 6.9% experienced PRD most of the time or always. In the multivariable logistic regression models, adolescents who experienced school-based interpersonal PRD most of the time or always had higher odds of poor mental health, sadness or hopelessness, suicidal ideation, suicide planning, and suicide attempts (adjusted odds ratios [AORs] = 3.39-5.19) compared to adolescents who never experienced PRD. The strongest associations were observed for victimization outcomes, including school bullying (AOR = 9.68), being threatened or injured on school property (AOR = 8.44), and physical dating violence (AOR = 7.68). CONCLUSIONS: School-based interpersonal PRD was associated with mental health problems, substance use, and victimization among racial/ethnic minority adolescents. These findings highlight the broad health correlates of school-based interpersonal PRD and emphasize the need for multilevel prevention and intervention strategies that strengthen individual coping while addressing the broader social and structural inequities that contribute to discriminatory experiences.