Helping Young Adults with Mental Health Problems: Providers Evaluate a Regional System of Care*

By Polgar, Michael; Cabassa, Leopoldo | Sociological Viewpoints, Fall 2007 | Go to article overview

Helping Young Adults with Mental Health Problems: Providers Evaluate a Regional System of Care*


Polgar, Michael, Cabassa, Leopoldo, Sociological Viewpoints


ABSTRACT

Community organizations provide help for young adults with mental health problems. How do these provider agencies perceive and evaluate their regional system of care? Survey questionnaire data from providers measure the accessibility, availability, and quality of services across 100 mental health, social service, and educational organizations. Social network data also provide peer-evaluations of each organization. Many providers view their system of care as frequently helpful, while recognizing limits in scheduling, providing prompt first appointments, and accepting all types of insurance. Representatives from organizations that offer a greater variety of services, particularly medical or transitional services to promote continuity of care, give better ratings to the system of care. Among mental health sector providers, peer-evaluations were associated with the range and strengths of an agency's inter-organizational relationships.

This research was supported by the National Institute of Mental Health (NIMH), R03-MH59108.

INTRODUCTION

Young adulthood, an age cohort following adolescence, is a complex and challenging period of life. Young adulthood commonly involves multiple transitions, often including moving to a new school and into the workforce, forming a new household and new relationships, and becoming a parent (Furstenburg et al. 2004; Gauthier and Furstenburg 2002). These transitions often require young people to affiliate with new organizations and institutions, including health and social service providers. Social research on transitions during young adulthood has provided insight into changing life-course patterns in developed nations like the United States (Settersten, Furstenburg and Rumbaut 2005) and into similar changes in developing nations (Council 2005). Demographic research has explored agecohort differences in markers of young adulthood, such as age at first marriage and age at parenthood (Fussel 2002).

Epidemiology about the U.S. shows that the prevalence of many mental health disorders, including substance use disorders, is elevated during young adulthood (Kessler 1995; Kessler 1994; Kessler and Zhao 1999). Like their peers, young adults who experience mental health problems face transitions in roles, relationships, responsibilities, and residence. While at elevated risk for the onset of mental health problems, young adults are less likely to be well insured (AHRQ 2005). They may face gaps or interruptions in health insurance coverage and in care, as they age out of institutions, organizations, and family-based insurance policies (American Academy of Pediatrics 2000; Olfson et al. 2000; Wellner 1999). It is therefore not surprising that research shows some delays in first treatment after onset of mental disorders (Christiana et al. 1998; Olfson et al. 1998).

There is expert consensus on the principle that children and youth with mental health problems should continue to have opportunities to receive mental health care as they transition into adult roles and responsibilities (American Academy of Pediatrics 2000; Clark and Davis 2000; Friedman, Kutash, and Duchnowski 1996; Stroul and Friedman 1986). According to the 1990 Individuals with Disabilities Education Act, transition means moving from school to post-school activities (Clark and Davis 2000). Needs for transitional services are most acute in agencies providing age-limited services for child welfare, juvenile justice, and special education (Clark and Davis 2000; Settersten et al. 2005). The systems of care for youth and for adults are linked but often distinct, encompassing multiple organizational sets, sectors, and services (Morrissey, Johnsen, and Calloway 2005) (Morrissey, Johnsen, and Calloway 1997). Therefore it is important to understand and evaluate system- and community-wide care for young people with mental health problems.

Evaluating the quality of public health systems for communities and populations is an important component of public health research (May et al. …

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