2018 State-of-the-Science Conference Proceedings: Executive Summary

This is the Executive Summary for the Learning and Working During the Transition to Adulthood Rehabilitation Research & Training Center\u27s 2018 State-of-the-Science Conference Proceedings. For more information and the full conference proceedings, please visit our website

State Efforts To Expand Transition Supports for Adolescents Receiving Public Mental Health Services

Summary: Recent publications and meetings highlight a great concern about the well-being of youth with serious emotional disturbance as they enter adulthood. The literature provides ample evidence that these young people struggle tremendously in meeting society’s expectations that they complete high school, get jobs, move out of the family home, become adult members of the community, and stay out of trouble. Testimonials from these youth and their families attest to the many challenges they face in achieving these goals. Unhappily one of the common challenges most often mentioned is an inadequate system response to their needs. Studies confirm that after age 16, and particularly after age 18, youth who have received significant supportive services often stop receiving these services. Furthermore, youth want many services but are unable to obtain them. Although numerous exemplary services have been developed for this population, these services appear to be offered on an extremely limited basis. This report summarizes findings from interviews with members of the Children, Youth and Families Division of the National Association of State Mental Health Program Directors. These members were reporting on transition-related activities in their states, focusing on efforts by state child mental health systems

State-of-the-Science Conference Proceedings: Improving Education, Training and Employment Outcomes for Youth and Young Adults with Serious Mental Health Conditions

The Learning and Working During the Transition to Adulthood Rehabilitation Research & Training Center (Learning & Working Center; LWC), UMass Chan Medical School, conducted a state-of-the-science conference, “Improving Education, Training and Employment Outcomes for Youth and Young Adults with Serious Mental Health Conditions.” The State-of-the-Science Conference was held during and at the end of the 31st Annual Research and Policy Conference on Child, Adolescent, and Young Adult Behavioral Health (a.k.a. The Tampa Conference) in Tampa, Florida sponsored by the University of South Florida between March 4-7, 2018. The LWC held a post-Tampa Conference “think tank” session with 28 participants to summarize the current knowledge base on the education, training, and work lives of youth and young adults with serious mental health conditions (SMHCs) and to identify future research needed to move the field forward. The proceedings herein include all conference papers and responses as well as final considerations for the future research directions in education, employment and policy and practice

2013 State of the Science Conference Proceedings: Tools for System Transformation for Young Adults with Psychiatric Disabilities

In 2013, the Learning and Working During the Transition to Adulthood Rehabilitation Research & Training Center, UMass Chan Medical School, successfully conducted a state of the science conference, “Tools for System Transformation for Young Adults with Psychiatric Disabilities.” The conference was held at Georgetown University National Technical Assistance Center for Children’s Mental Health on September 24-25th, 2013. We had two goals for this conference. Our first goal was to share and discuss the current state of research knowledge regarding practice and policy supports for strong educational and employment outcomes in young adults (ages 18-30) with psychiatric disabilities. Our second goal was to engage all attendees in prioritizing the knowledge that future research should address, to guide these systems’ efforts, to better launch and support these young adults’ long-term careers. The proceedings herein include all conference papers and responses as well as final considerations for the future research directions in education, employment and policy and practice. For more information, please visit our website

Pioneering Transition Programs; The Establishment of Programs that Span the Ages Served by Child and Adult Mental Health

Summary: There has been an increasing emphasis on improving supports to help vulnerable youth transition successfully from adolescence to adulthood. One of the major barriers to providing service continuity during this stage of life is the general practice of dividing mental health services into child/adolescent and adult service systems. This division is typically accompanied by agedefined eligibility or target population definitions, funding of programs that are age-defined, and service approaches that are tailored to the age group served. Those age-defined limits typically occur between ages18 and 21. While having age-tailored services for children, adolescents, and adults should improve the quality of care for those age groups, it often results in the unavailability of appropriate services for the “between” age of transition. In particular, these age-dichotomized practices force a disruption of service because as a result of a change in age, a youth who is receiving services through the child mental health system must leave that system and seek an appropriate one in the adult system. This shift from the child mental health system to the adult system is disruptive to existing therapeutic relationships. This can be very stressful and can ultimately result in a loss of service as a result of eligibility-related issues, covered services, and other factors. The purpose of this project was to provide insight regarding the establishment of pioneering transition programs and to identify processes that others might use to establish pioneering programs in their locales. In this report, pioneering transition programs refers to programs that serve youth continuously across the transition age, without disruption due to age changes. Operationally, this means that all of the pioneering programs described in this report, continuously serve a population from an age that only child/adolescent systems serve to an age that only adult systems serve. All of these programs are at least in part, funded by public mental health budgets. These programs were selected on this basis alone, the quality of the programs was not examined

Crossing the Divide: Programs that Bridge Child & Adult Mental Health Services [English and Spanish versions]

A Spanish translation of this publication is available to download under Additional Files below. Helping youth with serious mental health conditions transition from adolescence to adulthood has also meant transitioning them from child to adult mental health services, which are two very different systems. One’s age (e.g., 18, 21, or 25) often serves as the criteria that divides eligibility for one provider or system of service to another. The consequence of this practice is that mental health services are typically oriented to children or young teens or to mature adults, but are not tailored to the “between” ages of 14 – 25. Despite this discouraging scenario, there are mental health programs that succeed in serving youth and young adults across the “between” age without discontinuity of services. We researched these programs to learn about the processes they used to establish such services in 2006. “Pioneering programs” that continuously serve people from adolescence through early adulthood (typically 16-23) were identified. Administrators, program staff and other stakeholders from seven programs across the country that are partly publicly funded were interviewed using a standard set of questions. We wanted to find out how these transition programs came about. Additionally, we identified one state and one federal pioneering grant program that we included in this report. Originally published as: Research You Can Use, Issue 2, 2011. Also issued as Transitions RTC Research Brief 1, Feb. 2011

State Efforts To Expand Transition Supports for Young Adults Receiving Adult Public Mental Health Services

Summary: Psychiatric disorders present during the transition to adulthood (ages 16-30) impede the development of adult role functioning. Most adolescents with serious mental health conditions continue to have those conditions into adulthood, and many adults with psychiatric disorders developed those conditions at the threshold of adulthood (ages 18-21). Taken together, these findings from various studies confirm that, whether psychiatric disorders develop before or during the transition to adulthood, their presence seriously hinders the successful assumption of adult roles. These findings underline the importance of mental health (MH) services throughout this stage of life, and the need for interventions that facilitate the development of adult functioning. Adolescents and young adults with serious mental health conditions may receive services from a variety of service systems, including special education, child welfare, vocational rehabilitation and the like. However, the target populations for all but state MH systems are much more broadly defined than those with serious mental health conditions. Thus, it is important to know what is being done within state MH systems to address the transition needs of their adolescents and young adult clients. Further, transition support innovations from these systems could be a critical resource for the development and dissemination of programs, strategies, and technical assistance to improve transition support targeted at adolescents and young adults with serious MH conditions in all systems. A previous study of all U.S. state child MH systems showed that almost all were at least talking about the need to provide and improve transition support services, and most provided some, although limited, transition support services (Davis, 2001; Davis & Sondheimer, 2005). One of the ultimate limitations though, was the upper age limit of their services; most ending at age 18, with a smaller number extending to age 21. Thus, the primary agency that can address the continued transition and MH needs of young adults with serious MH conditions after ages 18-21 is the state adult MH system. There is no current literature on transition services or services for young adults within state adult MH systems. The present study was designed to parallel the earlier study of the child MH system, and describe efforts that state adult MH systems were making to address the needs of their young adult population transitioning into adulthood

Service System Supports During the Transition from Adolescence to Adulthood: Parent Perspectives

Summary: This report marks another important step in the ongoing efforts of the National Technical Assistance Center for State Mental Health Planning (NTAC) to focus attention on the need to improve and expand services and supports for young people with serious emotional disturbances who are making the transition from adolescence to adulthood. With funding from the Center for Mental Health Services (CMHS) of the Substance Abuse and Mental Health Services Administration, the National Association of State Mental Health Program Directors (NASMHPD) convened a National Experts Meeting on this topic in June 2000 in Washington D.C. NTAC continued its collaboration with CMHSR and funded a national survey of members of the Federation of Families for Children’s Mental Health on the transition of children from adolescence to adulthood - from the parent’s perspective. This report, Service Systems Supports During the Transition from Adolescence to Adulthood: Parent Perspectives, describes how parents feel about the quality of transition supports their child receives from various service systems, barriers to services, other system components they thought were important, and policy considerations