Andrea Cole

An Engagement Intervention for Young Adults with Serious Mental Health Conditions

Young adults with serious mental health conditions (SMHCs) often do not engage continuously with mental health services, and there are few engagement interventions designed for them. This qualitative study presents a blueprint for conceptualizing and developing an engagement intervention designed for young adults with SMHCs. The blueprint includes the following activities: (1) establishing a strong theoretical basis, (2) designing an initial manual based on previous research and practice, (3) systematically examining feedback on the manual from stakeholders, and (4) examining the feasibility, acceptability, and implementation demands of the intervention. Interviews, group discussions, and journaling were utilized to collect information from young adult participant-researchers, intervention facilitators (i.e., recovery role models and clinicians), and additional stakeholders (e.g., clinic staff and administrators) (N = 43). Analyses were performed with multiple coders using constant comparative methods. Results revealed critical information to improve the intervention, while also suggesting that the engagement intervention for young adults with SMHCs has promise.

Exploring the perceptions of workers on young adult mental health service (dis)engagement

Abstract The purpose of this research is to glean how social workers understand and address engagement in mental health services among transition-age youth and young adults (TAYYA). Five focus groups with 26 social workers were conducted. Workers were asked questions about their perspectives on the concept of engagement. Data analysis consisted of the constant comparative method. Results revealed that workers perceive many layers of the ecosystem impact TAYYA engagement in mental health services, including factors at the individual, meso, and systems levels. Results suggest that agencies may be able to increase TAYYA engagement by focusing on both worker and agency-level characteristics.

Social Context in Mental Health Service Use Among Young Adults

ABSTRACT Examining the sources of health communication that young adults with mental health challenges receive regarding service use is critical to curbing the societal concern of unmet mental health needs of this population. Semistructured interviews were conducted with 59 young adults, all of whom were diagnosed with a mood disorder and used public mental health services and additional public systems of care during childhood. Thematic analysis was utilized. Of the 59 participants, 45 nominated at least one supportive adult, with a total of 97 relationships analyzed. Results indicate that the majority of messages came from informal supports (e.g., family) who spoke positively about mental health services. Fewer messages came from formal supports (e.g., professionals). Messages included statements surrounding beliefs toward services, social norms (approval and disapproval), self-efficacy, and image considerations around using services. These findings can suggest ways that mental health service engagement interventions can leverage communication from informal supports. Future research can explore what messages young adults find most influential in persuading them to use mental health care consistently and the relationship between messages and health behavior.

Feeling Connected and Understood: The Role of Creative Arts in Engaging Young Adults in Their Mental Health Services

ABSTRACT Young adults face an elevated risk of developing mental illness yet are less likely to engage in mental health services than other adult age groups. The purpose of this article is to describe and present qualitative data related to the use of the arts in a group intervention designed to increase mental health service engagement in young adults with mental health challenges. Participants described feeling more understood and connected to group members through the creative arts activities and stated the use of the arts was positive, effective, and helpful in processing grief and loss. Research and practice implications are discussed.

Integrated, Overwhelmed, and Distanced: Narratives of Mental Health Among Young Adults With Prior Public System Involvement

Objective: Young adults who have been involved in child welfare and other public systems of care often have elevated rates of mental health disorders and low rates of mental health service utilization. This study explores the mental health narratives of young adults who previously were involved in public systems of care to understand how they make meaning of their symptoms and professional treatment. Method: We conducted in-depth, face-to-face interviews with 40 young adults (ages 18–25) who have mood disorders and histories of involvement in public systems of care. We used narrative and case-study strategies to identify and examine the mental health experiences of participants. Results: Three types of mental health experiences—classified as integrated, overwhelmed, and distanced—emerged from the analyses. Differences between these types are described. Conclusions: Young adults with histories of involvement in public systems of care have distinct mental health experiences. Practitioners should consider the diversity of these experiences to help young adults improve their overall well-being.

Mental health service use decision-making among young adults at clinical high risk for developing psychosis

Research has shown that young adults at clinical high risk (CHR) for developing psychosis have the capability to recognize that they have a problem and initiate mental health services, yet there is a paucity of theoretically based research examining this decision‐making process. This is critical to study because there are high rates of underutilization of mental health services among these young people. The following study explored the decision‐making process among young adults at CHR in order to understand mental health services utilization at a CHR clinic.

A Mixed-Methods Investigation Into the Perspectives on Mental Health and Professional Treatment Among Former System Youth With Mood Disorders

Research has shown that how people think about their health (or illnesses) shapes their help-seeking behavior. In this mixed-methods study, we employed a simultaneous concurrent design to explore the perceptions of mental illness among an understudied population: marginalized young adults. Participants were 60 young adults (ages 18–25) who had experienced mood disorders and used multiple public systems of care during their childhoods. Semistructured interviews were conducted to understand participants’ illness and treatment experiences during the transition to adulthood. A team of analysts used constant comparison to develop a codebook of the qualitative themes, and quantitative data were examined using SAS 9.3. Findings suggest that some theoretical categories identified in past illness-perceptions frameworks are salient to marginalized young adults (e.g., identity, management—or control—of symptoms), but both the developmental transition to adulthood and experiences with public systems of care add nuanced variations to illness and treatment perceptions. Our study demonstrates that young adults possess a set of beliefs and emotions about their mental health and help-seeking options that need to be better understood to improve engagement and quality of mental health care for this population. Implications for practice, research, and policy are discussed.