Young Adults' Recovery: Managing Change

Informed by relevant literature and combined with demographic, assessment, educational, and service information, program evaluations can identify key factor to manage change. An example follows. Background. Transition-aged youth (TAY), ages 18 to 26, have higher rates of Substance Use Disorders (SUD) than adolescents or adults over 26 years old. In 2019, 17% experienced a major depressive disorder with 12.1% having severe impairments. Overall, 30.6% experienced mental illness, and 9.7% had serious mental illness. Although TAY reported lower levels of recovery than older adults, predictors of behavioral health recovery for TAY have seldom been explored. Indiana’s Division of Mental Health and Addiction (DMHA) has funded TAY services since 2019 as an effort to positively impact this population. Methods. Qualitative information from seven currently DMHA funded programs were to support and supplement data analysis. A FFY21 Midwestern sample (n=2575) of treated young adults (ages 18-26) included 688 People of Color (POC; 12% of the sample were Black only, 0.04% Native American only, 0.06% Asian only, 5% other race only, 3% Multiracial, and 6% Hispanic); 0.73% were White only. Half were female. All youth had substance and/or mental health disorders. The Adult Needs and Strengths Assessment (ANSA) identified needs that interfered with functioning and strengths. Transportation, employment, and residential needs were identified early in care. Other need and strength items reflected status when treatment ended. In a secondary analysis of state-level data, a hierarchical linear regression predicted recovery, the rate of improved Total Actionable Items (Resolved/Ever identified needs). Predictive variables were directly entered into four blocks: 1 (race/ethnicity, gender, employment, transportation, housing stability), 2 (depression, anxiety, substance use [SUD]), 3 (involvement in recovery, SUD recovery support, social functioning, optimism), and 4 (duration of treatment, Motivational Enhancement Therapy [MET). Race was converted to POC and gender to ‘female’. Results. Each step of the regression model documented significant contributions of added variables (R2s =.013, .239, .319, .350). POC were less likely to improve than white individuals. Women were more likely than men to improve. Individuals with employment, transportation, or housing needs at the beginning of treatment were more likely to improve. Depression, anxiety, and substance use disorders decreased the likelihood of resolved needs. Poor social functioning and inadequate SUD recovery support at the end of treatment were associated with worse outcomes. Having a positive sense of oneself in the future (optimism) predicted recovery. Active involvement in recovery, longer service duration, and Medication Enhancement Therapy were related to higher rates of recovery. Discussion. In addition to addressing SUD and mental health concerns, young adults’ recovery is related to developmental tasks (employment, recreation, and social relationships), supporting involvement in managing one’s health, and developing resiliency. Attention to social determinants of health, such as transportation, is necessary for access to services and supports. Service adaptations for POC to increase involvement in recovery and equitable outcomes requires consideration and study. Managing change for TAY involves attention to developmental, cultural, behavioral health needs, the concurrent utilization/development of strengths, and monitoring progress.Division of Mental Health & Addiction, Indiana Family & Social Services Administratio

Experiences of Somali and Oromo Youth in the Child Protection System

Background: Little is known about the experiences or proportion of refugees involved with child protective services (CPS) in the United States, because they are not an identifiable group in CPS data systems. This study utilized an innovative data matching project to identify refugees in CPS data systems and explored the experiences of Somali and Oromo youth in Minnesota\u27s child protection system. Methods: A sample of 629 Somali and 62 Oromo youth who were involved with CPS between 2000 and 2013 were identified by linking datasets from the Minnesota Departments of Education and Human Services. Descriptive statistics, chi-square analysis, and t-tests were used to explore the proportion and characteristics of children involved with CPS, placement experiences, and child protection professionals\u27 documentation of families\u27 strengths and needs. Results: Somali and Oromo youth were involved with CPS at low rates (3.7%). Residential treatment facilities were the most common out-of-home (OHP) placement settings for Somali youth (41%), and almost a third of placements for Oromo youth were in a correctional facility (31.6%). Strengths identified for both groups included low alcohol and other drug use and few health issues. Needs included social support, mental health/coping support, and parenting skills. Conclusions: OHP settings for Somali and Oromo youth were highly restrictive. More research is needed to determine what is driving the high utilization of restrictive placements for Somali and Oromo youth, how accurately the Structured Decision Making tool assesses strengths and needs for families with refugee backgrounds, and how CPS professionals\u27 assessments of strengths and needs compare to the refugee families\u27 perceptions of their own strengths and needs

Teacher Role in Absenteeism: Discrimination, Identity, and Intersectionality -- A Person-in-Environment Analysis

As parents play an integral role in students’ absenteeism, so do teachers. A large part of the day, for students, is spent in schools and with teachers. In this chapter, the focus is on discrimination in teacher-student interactions and its direct influence on minority students regarding their school attendance problems. The data used, literature findings, results, and recommendations are shared from a person-in-environment perspective. The authors recommend exploring discrimination in teacher-student interactions as one mechanism to respond to absenteeism

Analysis of mothers’ perceptions affecting eating habits of young children with/without disabilities: A machine learning method

The purpose of this study was to confirm the mothers perceptions of the influence of eating habits of young children with/without disabilities. Through a survey study, the intersection between factors affecting understanding of baby food, practice of weaning food, and children's current eating habits was analyzed using a machine learning-based decision tree approach. Results indicate that, first, there was a significant difference in understanding of weaning foods between mothers of children with and without disabilities. The late timing of weaning foods was associated with an unbalanced diet and overeating. Second, there was a significant difference in the breastfeeding pattern before transitioning to baby foods in mothers of disabled infants and non-disabled infants. Before weaning, mothers of infants with disabilities were more likely to feed formula or a mixture of milk and formula. Third, the mother's job status during the weaning period showed a significant intersection with the current number of snacks, the preparation of weaning food, and the types of preferred snacks of the disabled infants. Discussion includes the need for diet education and related supports systematically for mothers of infants/children with disabilities

Does a Drop-in and Case Management Model Improve Outcomes for Young Adults Experiencing Homelessness: A Case Study of YouthLink

This study used two approaches to examine YouthLink as an example of a drop-in and case management model for working with youth experiencing homelessness. These approaches investigated the same group of 1,229 unaccompanied youth, ages 16 to 24 and overwhelmingly Black, who voluntarily visited or received services from YouthLink in 2011. Both approaches looked at the same metrics of success over the same time period, 2011 to 2016. One approach—Study Aim 1—examined the drop-in and case management model overall, asking whether YouthLink's service model resulted in better outcomes. It compared a YouthLink cohort with a group of highly similar youth who did not visit YouthLink but may have received similar services elsewhere. A second approach—Study Aim 2—investigated within the YouthLink cohort the ways in which YouthLink's drop-in and case-management approach worked toward achieving the desired outcomes

The intersectionality of gambling addiction recovery and mental illness: A machine learning approach

A machine learning algorithm identified that struggling with substance use, impulse control, education, and resourcefulness was the significant barriers to improvement from problem gambling in state-funded behavioral health services.  Interestingly, White adults were more likely to be improved from problem gambling than their peers of color. The machine learning-based gambling addiction recovery model could be a promising approach to detect the intersection of race/ethnicity, behavioral health challenges, and their improvement from problem gambling. It could eventually be a basis for developing a gambling addiction recovery model for adults with needs for gambling addiction treatment at the initial assessment. Such a relationship study will support the development of an efficient mental health and gambling recovery model.

Longitudinal Patterns of Strengths Among Youth with Psychiatric Disorders: A Latent Profile Transition Analysis

A better understanding of variability in the strengths of youth with psychiatric disorders is critical as a strength-based approach can lead to recovery. This study aimed to identify subgroups of strengths among youth with mental disorders and determine whether subgroups changes were associated with mental health recovery. Youth with mental disorders (N = 2228) from a statewide database were identified in the state fiscal year of 2019. Using the latent profile analysis and latent transition analysis, we identified three strength profiles (i.e., essential, usable, and buildable). Over 90% of youth sustained or developed strengths over time. Positive transitions were associated with mental health recovery, symptom reduction, and personal recovery. Buildable strengths supported youth’s personal recovery independent of improving mental health needs. The findings suggest that subgroups of strengths may be a promising source for planning and tracking youth’s progress and guiding clinicians to more efficiently allocate community-based resources

Does a Drop-in and Case Management Model Improve Outcomes for Young Adults Experiencing Homelessness: A Case Study of YouthLink

This study used two approaches to examine YouthLink as an example of a drop-in and case management model for working with youth experiencing homelessness. These approaches investigated the same group of 1,229 unaccompanied youth, ages 16 to 24 and overwhelmingly Black, who voluntarily visited or received services from YouthLink in 2011. Both approaches looked at the same metrics of success over the same time period, 2011 to 2016. One approach—Study Aim 1—examined the drop-in and case management model overall, asking whether YouthLink’s service model resulted in better outcomes. It compared a YouthLink cohort with a group of highly similar youth who did not visit YouthLink but may have received similar services elsewhere. A second approach—Study Aim 2—investigated within the YouthLink cohort the ways in which YouthLink’s drop-in and case-management approach worked toward achieving the desired outcomes. The results and their implications were discussed.The Kresge Foundatio

Young Adults with Behavioral Health Services and Justice System Involvement

Communimetrics highlights the team approach to sharing a vision and its goals via communication, while psychometrics focuses on efforts to identify, measure, and interpret psychological attributes and characteristics. I utilized ANSA data to identify unobserved subgroups and detect the intersectionality of dual system involvement (e.g., mental health and the criminal justice system), demographic characteristics, behavioral health needs, and race/ethnicity. Such intersectionality could be critical in the team process to assist and strengthen person-centered mental health recovery. I will also discuss the practical implications of critical factors associated with their behavioral health recovery to develop the outcome-oriented intervention

Intersection of Disability, School Climate, and School Violence in Inclusive Settings

Given that few studies have examined the intersectionality of bullying, disability, and self-efficacy, this study highlighted the intersection of disability, psychosocial characteristics, school violence, friendship, and teacher roles in examining the effect of school violence and school climate on self-efficacy among students with disabilities