Principal Investigator: Lisa Blitz, M.S., C.S.W. (JBFCS)

Funding: Center for the Study of Social Work Practice

Seriously mentally ill young adults between 18-25 years old are an important, vulnerable and little understood minority in the community mental health system. These individuals hover between the last developmental stages of adolescence and the beginnings of full adulthood and they struggle to get their needs met in a system not designed specifically for them. Clients in community mental health treatment programs are typically in their 30’s and 40’s. To a 20-year old who enters the adult mental health system for the first time, even a 35-year old fellow patient seems old. The older adult who struggles with his/her own illness can be frightening and intimidating to the younger person. This may have a negative impact on the latter’s ability to attach to the treatment program and acquire the help they needed.

Their dissatisfaction with program services, emotional reactions to the illness and disability of older clients, and difficulty in feeling a sense of belonging are expressed verbally and behaviorally in a number of ways. The dropout and rehospitalization rates for these young adults are high. They have a tendency to act out sexually, to use drugs and alcohol, or to create other crises which require immediate staff intervention.

The aims of this research are to discover the treatment issues and needs of young adults between the ages of 18-25 who have a serious mental illness and to use this information to design and develop a treatment program, within the context of an existing outpatient psychiatric treatment milieu. The study will be conducted at a JBFCS site which provides day treatment and psychiatric rehabilitation services for adults with severe and persistent mental illness.

At the beginning of the study, staff and clients will be consulted regarding problem formulation. Qualitative data will then be collected from 15 consenting clients. Based on the preliminary results of analyses of this data, specialized treatment services will be conceptualized, integrated into the exisiting psychiatric day treatment program, and offered to the young adults. The clients who participate in this new program will then be observed for 6 months. Information concerning clients’ adherence to treatment plans and progress toward goals will be monitored. In addition, follow-up meetings with clients will be held to assess their satisfaction with the program. Finally, the data will be analyzed to determine the extent to which the young adults expressed needs during treatment which were incorporated into the program and to determine the extent to which this was beneficial in helping them to achieve or maintain psychiatric stability and to progress towards their goals. This study may provide further information about the goodness of fit between client needs and program services. It will provide a baseline basis for comparisons in future studies.