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Challenges Faced by Transitional-Age Youth with Mental Health Concerns

     

The transition from adolescence to young adulthood is an exciting time for young people, marked by new relationships, as well as educational and vocational opportunities. While exciting and new, this transition time also brings challenges and stress, as young people learn to navigate their new responsibilities with increased independence.

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Description automatically generatedThe difficulties inherent in transitioning to adulthood are often felt most intensely by young people with chronic mental health concerns. It is estimated that between 6% and 12% of transition-age youth, defined as young adults ages 16-25, struggle with a serious mental health condition. Their journey into adulthood is complicated not only by issues related to their individual mental health, but also by the bewildering complexity of the new systems of care and services into which they find themselves abruptly transitioned.

The stress that the transition to young adulthood causes young people and their support system can exacerbate pre-existing mental illness. Chronic mental illness also causes delays in young people’s cognitive, social and emotional development. These delays can make already challenging tasks of young adulthood, such as independent decision-making and financial management, more difficult.

Given the challenges that transition-age youth with mental health conditions face, it is essential that they have access to robust and comprehensive mental health services.  However, this is often not the case. During this transition time, youth with chronic mental health conditions have needs that are distinct from younger children and older adults with mental illness. However, there is a lack of evidenced-based mental health care practices for transition-age youth. 

As a result, transition-age youth often find themselves abruptly aging out of mental health care services they received as children and teenagers, for varied reasons including changes in their insurance coverage and graduation from the public school system, which serves as a major entry point into mental health services for children. Upon aging out of these services, transition-age youth often find themselves without ready access to developmentally appropriate mental health care services.  Some transition-age youth find they don’t even qualify to receive adult mental health care services due to more restrictive eligibility criteria for adult services relative to child services.

For the minority of youth who maintain a connection to mental health care services during this transition time, many find that the services available to them don’t meet their needs. Others simply stop searching for care, deterred by the complexity of the system as well as stigma and shame that surrounds mental illness. This results in the transition-age years being a major time for youth to dropout of mental health care treatment all together, with long-term consequences. 

However, there are things family and friends can do to help transitioning age youth at this critical time. See the accompanying post with Advice for Families

By
Stephanie Fosbenner, M.D.
Cheryl Al-Mateen, M.D.
Members of the APA Council on Children, Adolescents and Families, Interest group on Transitional Aged Youth

References

Davis, M., Sabella, K., Smith, L. M, & Costa, A. (2011). Becoming an Adult: Challenges for Those with Mental Health Conditions. Transitions RTC. Brief 3.

Munson et al. (2016). Cornerstone program for transition-age youth with serious mental illness: study protocol for a randomized controlled trail. Trials. 17(573).

Copeland et al. (2015). Increase in untreated cases of psychiatric disorders during the transition to adulthood. Psychiatric Services. 66(4), 397-401.

     

Patients and Families

 

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