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OBJECTIVE: Substance use (SU) is common among adolescents and young adults, including those experiencing early psychosis. Coordinated Specialty Care (CSC), a community-based multidisciplinary team-based service model, is increasingly used to support people experiencing first-episode psychosis. In addition to prescribers, clinicians, and vocational specialists, CSC includes peer support specialists who use their own living/lived experience with mental health and treatment to engage and support young people with their recovery goals. Peer support is also foundational in SU recovery. However, little is known about how peer support specialists navigate client SU in CSC. The purpose of this article is to detail CSC peer support SU practice. METHOD: Informed by community-based participatory research methods, a PhD-level qualitative researcher and a former peer support specialist conducted virtual interviews with 20 CSC peer support specialists. A multidisciplinary team including researchers with lived mental health experiences thematically coded interview transcripts. RESULTS: A spectrum of CSC peer support specialist SU responses emerged: (a) leverages lived SU experiences; (b) does not explore SU with clients; (c) shares client SU information with the CSC team; (d) educates, mentors, and advocates; (e) shares SU consequences and/or challenges substance use; (f) nonjudgmental, nondirective SU exploration; and (g) promotes harm reduction. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: CSC peer specialist SU practice is influenced by several contextual tensions that must be better understood and addressed in future research to improve peer SU practice. Study findings speak to practice nuances that are helpful for CSC peer support training and supervision. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Increasingly, US community mental health settings are integrating professional near-age youth peer support providers to improve youth service engagement and outcomes. Youth peer specialists (YPS) use their lived and living experiences with a mental health diagnosis to validate, empathize, and provide individualized support, while also improving their program's overall responsiveness to young people's needs. Although promising, these roles tend to lack clarity-responsibilities vary immensely, and turnover is high. Examining near-age youth peer on-the-job experiences is needed to design effective on-the-job supports. Using community-based participatory action research methods, young adults with lived experience worked in partnership with a PhD-level qualitative researcher to design, recruit, conduct, and analyze in-depth-interviews with current and former near-age youth peer providers. Ten young adult peer mentors in Massachusetts completed interviews that revealed near-age youth peer role relational complexity. Five relational aspects were identified requiring relational practice skills and self-awareness, including relationships with (1) self, (2) clients, (3) supervisors, (4) non-peer colleagues, and (5) other near-age peer providers. Near-age peers experience relationship-related struggles with non-peer identified colleagues who do not understand nor value the near-age peer role. Findings expand on current near-age peer practice and associated on-the-job challenges. Training, supervision, and professional development activities that target these five relational areas may improve YPS on-the-job wellbeing, decrease YPS turnover, and improve youth client outcomes.
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Serious mental health diagnoses are prevalent among youth who "age out" of foster care by reaching the maximum age for child welfare service eligibility. Post-emancipation, little is known about how youth engage in community mental health services, or leverage informal social networks, to navigate independence. Twenty emancipating youth completed three interviews over 16 months. All emancipated into poverty; most lived alone and initially connected to adult community mental health teams. Four service use and informal support profiles emerged from analysis: (1) Navigators (n = 2) actively used mental health services and provided limited informal support; Treaders (n = 9) passively used mental health services and heavily exchanged informal support; Survivors (n = 5) used mental health services when in crisis and heavily provided informal support; and Strugglers (n = 4) avoided mental health services and took resources from informal connections. Findings have implications for both child and adult mental health and social service providers.
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Servicios Comunitarios de Salud Mental , Salud Mental , Adolescente , Niño , Humanos , Adulto Joven , Apoyo Social , Servicio Social , PobrezaRESUMEN
AIM: Despite known prevalence of substance use (SU) among young people experiencing early psychosis and increasing evidence for the relationship between certain substances (e.g., cannabis) and psychosis, there are no specialized interventions developed for effectively addressing substance use among young people participating in coordinated early psychosis services. This study elicited the perspectives of young people with early psychosis participating in Coordinated Specialty Care (CSC) programs about their substance use, including their motivations and concerns around their use, and their ideas on how to best support young people who are interested in reducing or quitting substance use. METHODS: We recruited young adults (ages 18 to 30) from CSC programs across Texas through flyers sent to program staff inviting young persons willing to talk about substance use to engage in a 60-90 min person-centered, semi-structured, audio-recorded Zoom interview. RESULTS: A total of 22 young adults were recruited and 18 completed an interview. Participants described mixed positive and negative responses to substance use, and while many understood the importance of discontinuing substance use, many expressed ambivalence related to social, contextual, mental and physical factors that motivated them to keep using. Participants desired practical substance use information, opportunities to explore their substance use ambivalence in supportive relationships, positive peer communities to support healthy choices, help engage, with work, school, and hobbies, and strategies for addressing psychological and physical pain that did not include substance use. CONCLUSION: Study findings illuminate what motivates young people with early psychosis to initiate, continue, or cut back on substance use, and ideas for CSC practices for exploring substances and helping young people to reduce substance use.
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The U.S. is facing an unprecedented youth mental health crisis. Translating the findings from mental health intervention trials into large scale, accessible community-based services poses substantial challenges. Examination of state actions as a result of research-informed federal policy to improve youth access to quality mental healthcare is necessary. This mixed-methods study examines the implementation of evidence-informed multidisciplinary coordinated specialty care (CSC) for first-episode psychosis (FEP) services across Texas. The study explores CSC service model components, site location and participant characteristics, and implementation barriers. This cross-sectional study analyzes State of Texas public mental health administrative data from 2015 to 2020, including CSC site (n = 23) characteristics and CSC participant (n = 1682) demographics. Texas CSC site contracts were compared to OnTrackNY, a leading CSC model in the U.S. for CSC service element comparison. In-depth interviews with CSC Team Leads (n = 22) were analyzed to further understand CSC service elements and implementation barriers using qualitative content analysis. CSC was implemented across three waves in 2015, 2017, and 2019-serving 1682 participants and families. CSC sites were located in adult mental health programs; approximately one third of CSC participants were under 18 years. CSC implementation challenges reported by Team Leads included: staff role clarification, collaboration and turnover, community outreach and referrals, child and adult service billing issues, and adolescent and family engagement. Study findings have implications for large state-wide evidence-based practice implementation in transition-to-adulthood community mental health.
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Trastornos Psicóticos , Adolescente , Niño , Humanos , Estudios Transversales , Trastornos Psicóticos/terapia , Proyectos de Investigación , Texas , AdultoRESUMEN
PURPOSE: To improve sustainability of Coordinated Specialty Care (CSC) for a recent onset of psychosis, a better understanding is needed regarding how non-academic-affiliated community mental health centers blend CSC service elements and select key performance metrics to evaluate their approach. METHODS: A quality and evaluation team embedded within a large community mental health center partnered with CSC site leadership to implement CSC and design a program evaluation strategy informed by CSC research literature. Clinical, family, vocational, and psychiatry services participation, exits, key performance indicators, and standardized measures were examined for participants (n = 47) enrolled for 12-months. RESULTS: Mean service participation was 55 h (SD = 23.5) in the first 12-months (approximately 4.70 h/month). All participated in clinical; 87% in psychiatry; 67% in vocational; and 57% in family services. Sixty-one percent had planned service exits; 39% had unplanned exits. Across the 12-months, 83% were employed or in school; 72% were not psychiatric hospitalized. CONCLUSIONS: CSC participation and outcomes were similar to the limited research examining both together. Understanding service participation and provider adjustments to sustain CSC is critical in community mental healthcare settings that rely on fee-for-service billing mechanisms. Findings have implications for national CSC data harmonization and sustainability efforts.
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Servicios de Salud Mental , Trastornos Psicóticos , Humanos , Evaluación de Programas y Proyectos de Salud , Trastornos Psicóticos/terapia , Trastornos Psicóticos/psicología , Centros Comunitarios de Salud Mental , Instituciones AcadémicasRESUMEN
A better understanding of the transition from child to adult community mental health services is important given the high rates of service drop-out. Conducting longitudinal research is challenging during a major service provider change. Developmentally-typical transition-to-adulthood instability can deter study engagement. This study examines the efficacy of creative technology-based strategies to recruit and engage adolescents and young adults (AYA) with serious mental health diagnoses in a qualitative study during their transition from child to adult services. Participants were recruited from one agency to complete three in-depth qualitative interviews and monthly surveys exploring mental health service experiences over 12-months. Participants received a smartphone and data plan for 6-months at initial interview, $50 at 6-month interview and $55 at 12-month interview. Four research assistants used a shared Google Voice account to text monthly online surveys and to communicate with participants. 19 participants enrolled; 74% remained enrolled across the 12-months. Smartphones and data plans were not effective in recruiting nor sustaining study engagement for most participants. Participants preferred a mix of texting and phone calls to prompt study engagement; 60% of online surveys were completed. Unanticipated participant-researcher communication outside of research scope suggests that the formation of strong relationships and additional support during this transitional time is critical for sustained study engagement. Study findings have practical implications for social work longitudinal research design and effective study implementation. Future social work research is warranted on innovative strategies to boost study and service engagement among AYA with serious co-occurring mental health and developmental instability.
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Purpose. Transition-age youth (TAY) who have experienced or are experiencing complex trauma, system involvement and homelessness are at increased risk for serious mental health needs and related challenges. However, these vulnerable and historically marginalized TAY typically have low rates of mental health service engagement. This study examines how and why TAY experiencing system involvement, homelessness, and serious mental health and substance use symptoms engage in mental health services, and what facilitates and/or hinders their engagement in services. Methods. Twenty-one TAY completed a virtual interview about their previous and current mental health service experiences, and why they did or did not engage with mental health services. A modified grounded theory qualitative analysis approach was used to understand how participants' personal sense of meaning interacted with programmatic factors to construct participant experiences with mental health services. Results. Most participants (81%, n = 17) received mental health services, namely psychiatry (76%, n = 16) and counseling/therapy (48%, n = 10), and peer support (10%, n = 2). Participants described their mental health service experiences along three interpersonal and relational continuums between themselves and their providers: feeling (mis)understood, being treated with (dis)respect, and experiencing (dis)trust. Discussion. Study findings reveal that for these particularly vulnerable and marginalized TAY, relational and interpersonal factors significantly influenced their engagement in mental health services. Study findings call for providers to re-imagine their working alliance with highly vulnerable TAY through culturally-attuned practices that promote understanding, respect, and trust. Findings also call for TAY-serving programs and policies to re-imagine peer support as a mental health service option for this highly vulnerable population.
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OBJECTIVE: This report examined challenges and adaptations to sustaining multidisciplinary team-based coordinated specialty care (CSC) for early-onset psychosis during the COVID-19 pandemic in Texas. METHODS: In June 2020, team leaders from 23 Texas CSC sites participated in semistructured phone interviews about CSC implementation barriers and adaptations. Transcripts were analyzed with thematic analysis. RESULTS: CSC implementation barriers included difficulty delivering critical CSC components (i.e., community education and vocational exploration) and client recruitment limitations. Virtual technology integration (i.e., texting and videoconferencing) largely sustained CSC outreach, service delivery, and client engagement. However, sites faced virtual competency and accessibility issues, exhaustion from virtual technology use, lack of structural support, and unanticipated disengagement. CONCLUSIONS: The surveyed sites rapidly integrated virtual technology into CSC delivery. This integration promoted CSC engagement during the pandemic, especially in rural areas, and increased insight into what resources and policies are needed to sustain virtual technology use among community mental health providers.
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COVID-19 , Humanos , Pandemias , Tecnología , Texas , Comunicación por VideoconferenciaRESUMEN
OBJECTIVE: This study explored the pathways to employment, education, and/or disability among young adults with First-Episode Psychosis (FEP) with the intent to reduce poverty and disability among this population. METHOD: Using a critical case design, 10 young adults (ages 21-28) completed two qualitative interviews exploring the key moments that influenced their pathway toward employment and education or disability after experiencing a first-episode of psychosis. Participants had lived experience of an FEP, had completed a Coordinated Specialty Care (CSC) program, and were members of the Early Assessment and Support Alliance's Young Adult Leadership Council (YALC). Qualitative analysis was completed using a four-step template approach and focus group. RESULTS: Early stigmatizing behavior by hospital staff and the diagnostic label of psychosis challenged participants' self-identity and self-confidence which led to a pause in vocational activities. Meeting peers (i.e., other individuals who had experienced a first-episode of psychosis) through their CSC program normalized their psychosis diagnosis and alleviated feelings of self-stigma; this was integral in returning to and initiating new employment and education goals. YALC involvement provided opportunities for practicing work skills, such as public speaking, and additional peer support that further eradicated self-stigma and improved connection to employment. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Implications for CSC models include broad consideration of the ways that early psychiatric labeling can construct self-stigma, and how this phenomenon stunts the self-confidence needed to pursue employment and education goals. Specific recommendations include utilizing peer connections, peer spaces, and peer-delivered anti-stigma interventions to enhance employment and education pathways. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Personas con Discapacidad , Trastornos Psicóticos , Adulto , Escolaridad , Empleo , Humanos , Trastornos Psicóticos/psicología , Autoimagen , Adulto JovenRESUMEN
Objective: Increasingly, community mental health providers are implementing multidisciplinary treatment models blending child and adult evidence-based practices to boost young adult engagement. Although promising, limited research examines how and why young adults disengage from these new models. This study examines provider documentation of treatment discharges to create a more developmentally-attuned young adult service exit typology. Method: Service records of 18-25 year-olds (n = 124) who discharged from a young adult-tailored multidisciplinary treatment team over a 5-year period were analyzed. A research team conducted a systematic content analysis of discharge forms and service notes. Planned and unplanned exits emerged as primary categories, each having distinct subcategories with noted prevalent associated experiences. Results: Participants (n = 124) were enrolled between 7 days to 3.80 years (M = 11.41 months) prior to exit. Those with "planned" exits (n = 71) were enrolled longer than those with "unplanned" exits (n = 53), means respectively 13.17 versus 9.06 months. Planned exits included: transitions either to a lower, similar or higher level of care, a return to previous provider, or insurance issues. Moving outside team geographic area contributed to planned and unplanned exits. Unplanned exits were disproportionately found among participants who were Black, had justice involvement histories, and/or experienced housing instability or homelessness. Conclusions and Implications for Practice: Young adult service exits are complex; planned exits are not always positive and unplanned exits are not always negative. Provider and research use of this new service exit typology has particular implications for identifying engagement disparities-and further tailoring models to be more attractive, culturally responsive, and impactful with young adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Inestabilidad de Vivienda , Trastornos Mentales , Niño , Servicios de Salud Comunitaria , Familia , Humanos , Trastornos Mentales/terapia , Salud Mental , Adulto JovenRESUMEN
Adult providers struggle to engage 18-25-year olds despite high rates of serious mental health challenges observed among this age group. A new model, called "Emerge," combines the intensive outreach and multidisciplinary team-based approach used in Assertive Community Treatment with Positive Youth Development principles and practices used in the Transition to Independence Process Model. Emerge bridges youth and adult services, focuses on supporting transition-to-adulthood milestone achievement, and is a sister team to Coordinated Specialty Care for recent psychosis onset. This paper describes Emerge components, practices, and findings from a feasibility pilot study using agency administrative data. Most prevalent goals were employment and social support/relationship related. The majority made progress on individual goals, engaged in employment and education, and experienced decreased psychiatric hospitalizations. Community mental health policy and practice implications are discussed, including funding blending of evidence-based practices for those transitioning to adulthood with youth-onset serious mental health conditions.
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Servicios Comunitarios de Salud Mental/organización & administración , Atención a la Salud , Trastornos Mentales/terapia , Adolescente , Adulto , Empleo , Práctica Clínica Basada en la Evidencia , Necesidades y Demandas de Servicios de Salud , Humanos , Trastornos Mentales/diagnóstico , Salud Mental , Evaluación de Necesidades , Proyectos Piloto , Apoyo Social , Adulto JovenRESUMEN
Serious mental health conditions peak in prevalence and incidence during the transition to adulthood (approximately ages 16-25). Young adults are at high risk for discontinuation of care when no longer eligible for child mental health services. This study uses state administrative data to examine service continuation among those aging out of child system services in Texas (N = 3135). Most (63.5%) did not enroll in adult services following their 18th birthday. Binary logistic regression analyses found that significant predictors of child-to-adult service continuation included (1) a serious primary mental health diagnosis (i.e., schizophrenia, bipolar disorder, major depressive disorder), (2) risks to self and others, and (3) number of prior-year mental health services received. These findings suggest that historical mental health policies and practices may contribute to service disconnection at age 18 in Texas. Implications for mental health policy and system reform locally and nationally are discussed.
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Servicios de Salud del Adolescente/estadística & datos numéricos , Servicios de Salud del Niño/estadística & datos numéricos , Servicios Comunitarios de Salud Mental/estadística & datos numéricos , Continuidad de la Atención al Paciente , Trastornos Mentales/terapia , Transición a la Atención de Adultos , Adolescente , Adulto , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Trastornos Mentales/epidemiología , Texas , Adulto JovenRESUMEN
Transition-age youth (TAY, ages 14-26) diagnosed with serious mental health conditions are at high risk for vocational struggles. This paper examines the implementation and process evaluation of Individual Placement and Support (IPS) and Supported Employment enhanced to better meet developmental needs of TAY. Enhancements include the integration of a TAY development focus, engagement best-practices, Supported Education and Peer Support. Community mental health providers participated in a process evaluation to explore the feasibility of a larger scale implementation. Common organizational barriers were encountered across provider sites including: leadership support, agency structures and funding mechanisms; compounded by the complexity of bridging child and adult systems. Findings have implications for both child and adult community mental health providers as they adapt and integrate programming for TAY.
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Empleos Subvencionados , Trastornos Mentales , Adolescente , Adulto , Niño , Humanos , Liderazgo , Rehabilitación Vocacional , Texas , Adulto JovenRESUMEN
OBJECTIVE: For interventions, like the Transition to Independence Process (TIP) Model, to be implemented effectively, efficient and accessible quality assurance tools are needed. The purpose of this article is to describe the process of developing an online staff self-report quality assurance tool for a key process in the TIP Model: the TIP Solution Review (TSR) and to provide data on the acceptability and perceived impact of both the measure and the TSR process. METHOD: We used an iterative approach to pilot test and seek feedback from multidisciplinary teams trained in TIP. Initially, a team of 7 completed the online TSR Quality Assurance Scale, followed by a focus group. The tool was refined and administered to three additional TIP Model trained teams (n = 23 practitioners) in 3 different states. Team supervisors (n = 3) were then interviewed about their perceptions of the TSR process and the new tool. Thematic analyses were conducted on open-ended survey questions and interview and focus group responses. RESULTS: Findings suggest the new tool and TSR processes are acceptable and feasible. Staff feedback provided for further TSR process refinement. Conclusions and Implications for Clinical Practice: The process of developing, refining and evaluating a tool to capture the TSR (an important TIP quality improvement process) led to increased TSR process specification. Findings have implications for systematically guiding how intervention developers structure supervision and preparation of intervention planning and delivery. Future research will more rigorously test the tool to establish its empirical properties and effectiveness in assessing adherence to TSR procedures. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Práctica Clínica Basada en la Evidencia , Personal de Salud , Investigación sobre Servicios de Salud/métodos , Ciencia de la Implementación , Trastornos Mentales/terapia , Garantía de la Calidad de Atención de Salud , Mejoramiento de la Calidad , Transición a la Atención de Adultos , Adolescente , Adulto , Práctica Clínica Basada en la Evidencia/normas , Personal de Salud/normas , Humanos , Proyectos Piloto , Garantía de la Calidad de Atención de Salud/normas , Mejoramiento de la Calidad/normas , Transición a la Atención de Adultos/normas , Adulto JovenRESUMEN
Significance: About 50% of young adults with schizophrenia, bipolar disorder, and other severe mental illnesses smoke tobacco, but few studies have evaluated interventions for this group. Methods: We conducted a randomized pilot study among 58 young adult smokers with severe mental illnesses comparing a brief interactive web-based motivational tool, Let's Talk About Smoking, to computerized standard education from the National Cancer Institute. An additional 23 subjects received minimal tobacco assessment at baseline and no intervention, providing a comparison condition for naturalistic cessation behavior. All participants (total n = 81) were assessed for smoking and breath carbon monoxide at baseline and 14 weeks and had access to standard cessation treatments. Results: The 81 participants were stable outpatients ages 18-30 (mean 24.8 years): 43.2% were diagnosed with schizophrenia-spectrum disorders, the remainder with severe mood and anxiety disorders. They smoked 14.6 ± 10.2 cigarettes per day. All participants completed their assigned intervention; 83.4% of Let's Talk About Smoking users and 71.4% of standard education users rated their intervention "good" or "very good." At 14 weeks, less than 15% of participants in all conditions had used additional cessation treatment. Let's Talk About Smoking users were more likely to have biologically verified abstinence at 14 weeks than standard education users (14.8% vs. 0%; X2 = 3.7, p = .05). None of the participants in the naturalistic comparison condition were abstinent at 14 weeks. Conclusions: Interactive, web-based motivational interventions are feasible and promising for smoking cessation among young smokers with severe mental illnesses. Such interventions warrant further study among this group of smokers. Implications: Young adult smokers with severe mental illnesses are a vulnerable population that, without intervention, goes on to experience disparate morbidity and mortality. Brief, easily disseminable interventions are needed to facilitate cessation in this group. This pilot research indicates that brief, technology-delivered, motivational interventions that are tailored for this group may be able to activate a significant number to quit without additional cessation intervention.
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Internet , Trastornos Mentales/terapia , Índice de Severidad de la Enfermedad , Fumadores , Cese del Hábito de Fumar/métodos , Fumar/terapia , Terapia Asistida por Computador/métodos , Adolescente , Adulto , Femenino , Humanos , Internet/tendencias , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Proyectos Piloto , Fumadores/psicología , Fumar/epidemiología , Fumar/psicología , Cese del Hábito de Fumar/psicología , Adulto JovenRESUMEN
Peer providers are a promising practice for transition-age youth community mental health treatment engagement and support, yet little is known about the experience of being a young adult peer provider or what helps to make an individual in this role successful. Utilizing a capital theory lens, this study uses data from focus groups (two with young adult peer providers and two with their supervisors) to examine facilitators of young adult peer provider success in community mental health treatment settings. Eight factors were identified as critical to young adult peer provider on-the-job success: persistence, job confidence, resilience, job training, skilled communications with colleagues, regular and individualized supervision, support from colleagues, and family support. Findings suggest that young adult peer providers may benefit immensely from an agency level focus on fostering social organizational capital as well as more individualized efforts to increase cultural, social, and psychological capital through training and supervision.
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Servicios Comunitarios de Salud Mental/métodos , Empleo/psicología , Trastornos Mentales/rehabilitación , Tutoría/métodos , Grupo Paritario , Apoyo Social , Adolescente , Adulto , Boston , Estudios Transversales , Femenino , Grupos Focales , Humanos , Masculino , Investigación Cualitativa , Adulto JovenRESUMEN
Effective services are needed to assist young people with serious mental health conditions to successfully transition to employment or education, especially among those with intensive adolescent mental health service utilization. To meet these needs, the Individual Placement and Support (IPS) model of supported employment was adapted and its feasibility was tested in a psychiatric treatment program for early-emerging adults. Participants were 17-20 years old (mean age = 18.5 years). Most were African American, under the custody of the state, with a primary mood disorder diagnosis. Adaptations to IPS included adding the following: near age peer mentors, a supported education component, and a career development focus. This open trial feasibility study tracked the model's development, recruitment, and retention and tracked vocational and educational outcomes for 12 months. Model refinement resulted in the development of a separate educational specialist position, greater integration of the peer mentor with the vocational team, and further specification of the role of peer mentor. There was an 80% retention rate in the feasibility evaluation. Of the 35 participants, 49% started a job and/or enrolled in an education program over the 12-month period.
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Empleos Subvencionados , Trastornos Mentales/rehabilitación , Rehabilitación Vocacional/métodos , Adolescente , Adulto , Estudios de Factibilidad , Femenino , Humanos , Entrevista Psicológica , Masculino , Trastornos Mentales/terapia , Salud Mental , Servicios de Salud Mental , Adulto JovenRESUMEN
This qualitative study explores the experiences of emerging adults with serious mental health conditions (e.g., bipolar disorder, posttraumatic stress disorder) before and after they emancipate from the child welfare system and exit a transitional living program. Sixteen participants were interviewed before and 13 were interviewed after aging out. Findings suggest that transitional living programs services were appreciated for the relationships and safety net they fostered. Future plans were positive, but vague, and worries about the future were prevalent. Struggles with independence post-emancipation were common despite adult service use. Additional research is needed to understand how to best support these at-risk emerging adults.
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Trastorno Bipolar/terapia , Protección a la Infancia , Desinstitucionalización , Trastorno Depresivo Mayor/terapia , Trastornos Psicóticos/terapia , Trastornos por Estrés Postraumático/terapia , Transición a la Atención de Adultos , Adaptación Psicológica , Adolescente , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/psicología , Niño , Servicios de Salud Comunitaria , Comorbilidad , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/psicología , Femenino , Hogares para Grupos , Jóvenes sin Hogar/psicología , Humanos , Vida Independiente/psicología , Entrevista Psicológica , Masculino , Motivación , Evaluación de Necesidades , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Tratamiento Domiciliario , Seguridad Social , Estigma Social , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Adulto JovenRESUMEN
There is little information on trauma, posttraumatic stress disorder (PTSD), and associated risk factors in transition-age youth with mental health conditions. This study aimed at understanding the correlates and predictors of PTSD in 84 transition-age youth, between 16 and 21 years old, residing in supported community housing. Chi-square analyses and t tests were used to compare youth with a diagnosis of PTSD to those without a PTSD diagnosis. Stepwise logistic regression analyses were performed to identify unique predictors of PTSD. Of the 84 individuals, 79 (94%) reported a history of trauma, of whom 30 (36%) had PTSD. Sexual abuse was significantly associated with a PTSD diagnosis (r = .47) and the only unique predictor of PTSD (Cox r(2) = .20). Transition-age youth in supported community housing had higher rates of trauma exposure and PTSD than the general adolescent population, suggesting the need for routine assessment and treatment of PTSD in this population.