Study: Most Discontinue Mental Health Services as They Transition to Adulthood

A new study by researchers at the Silver School of Social Work has found that among 60 young adults with a history of significant mental health difficulties, few used psychiatric services, medications, or other mental health services on a continuous basis as they transitioned to adulthood.

The qualitative study by associate professor Michelle Munson, professor James Jaccard, and fellow researchers in Georgia and Ohio sheds light on the problem of untreated mental illness among young adults nationwide, and adds to growing evidence that young people often discontinue mental health services when exiting child welfare, juvenile justice, mental health, and other publicly funded systems of care.

In the study, “Static, dynamic, integrated, and contextualized: A framework for understanding mental health service utilization among young adults,” published in the journal Social Science and Medicine, Jaccard, Munson and colleagues use in-depth, semi-structured interviews to explore the experiences of people ages 18-25 in one Midwestern state, and the reasons why in most cases their engagement with mental health services turned sporadic or came to a stop.

By design, all 60 participants included in the study were struggling with continued mood and emotional difficulties and shared three childhood experiences—mood disorder diagnosis, use of public mental health services, and experience with social service systems.

Results showed that few of the study participants were continuous service users during the transition to adulthood, with most either discontinuing services (42 percent) or showing single gaps in service use (22 percent) or multiple gaps (15 percent) as they moved from adolescence to adulthood—a juncture when young adults are solidifying their identity, making life transitions, and institutionally aging out of child social service systems. The reasons for not using services consistently ranged from participants’ doubts about the efficacy of medication and concerns about their “image,” to insurance barriers and long wait times for counseling and other types of assistance at overburdened social service agencies.

The study provides future researchers with a mid-level theory—an integrated and comprehensive framework for further research and understanding about the sporadic use of mental health services by young adults. The framework includes the dynamic nature of service use and a template of multi-level factors to consider at any one point in time.

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