Adolescents remain disproportionately underserved compared to other age groups. This is especially concerning given that most lifetime mental health disorders emerge during adolescence, making timely intervention critical to long-term well-being. By comparing adolescents with Medi-Cal to those with commercial insurance and to their adult counterparts, this study addresses an urgent gap in understanding how systemic insurance structures may contribute to persistent inequities. '

Findings: When comparing adolescents to adults, only 7.1% of adolescents had delayed care versus 10.0% of adults, initially suggesting that adults were more likely to report unmet needs. However, when examining respondents who attested to experiencing psychological distress in the previous 12 months, disparities became much more apparent. Among adolescents who experienced psychological distress (31.8% of the sample), 45 out of 69 (65.2%) respondents had delayed care. When examining the adults that attested to psychological distress in the last 12 months (2.89% of the sample), 625 out of 1531 (40.8%) respondents also had delays in care. Logistic regression confirmed this relationship that adolescent individuals who experienced psychological distress were 4.53 times more likely to have delayed care. Similarly, adults who experienced psychological distress were 3.75 times more likely to have delayed care.