Deinstitutionalization in the 1950s and 1960s led to the closure of most psychiatric institutions and a shift to community-based mental healthcare. However, services were designed for chronic patients and did not meet the needs of young adults experiencing early-onset serious mental illness. Young adulthood from 18-25 is a developmental transition period focused on achieving independence through education, employment, relationships and other criteria. Research shows serious mental illness is associated with lower educational achievement, higher unemployment and homelessness, and involvement in the criminal justice system for young adults, indicating difficulties with this transition. Tailored mental health services are needed that address the unique developmental needs of this emerging adult cohort.

1. Young adults with serious mental
illness: The developmental needs of
a service population
Michaela I. Fissel
Central Connecticut State University

2. Deinstitutionalization
Deinstitutionalization was a policy initiative that restructured the
mental health service system at the federal and state levels, shifting
delivery of services into a community-based setting (GAO, 2008).
–
1955 559,000patients in psychiatric institutions*
1960 – 90% of state psychiatric institutions
closed*
1990s – 70,000patients remained
institutionalized*
Policy makers focused on restructuring the mental health system at the
highest level, resulting in the majority of community based-services being
designed using a clinical approach and for the chronic patients of the
1960s (Bachrach, 1984).
*Lamb, Bachrach, &Kass (1992)
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3. For the new cohort of young adults
experiencing the onset of serious
mental illness, diagnosis does not
mean a lifetime of hospitalization
(Bachrach, 1984) .
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4. Introduction
Currently, young adulthood is defined as ranging from
approximately 18 through 25 years of age (GAO, 2008). The
main objective while transitioning throughout those years is to
achieve adulthood (Arnett, 2000).
Achievement of adulthood is measured by criteria, including:
•graduation,
•employment,
•education,
•living situation,
•relationships
•parenthood (Gralinksi-Bakker, Hauser, Billings, Allen, Lyons, Melton, 2005).
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5. Introduction Continued
Recently, a study found that the number of criteria achieved by
the average 30-year-old in 2001, had been achieved by
25 in the early ‘70s (Henig, 2010).
This finding indicates that the trend in the achievement of
adulthood has been extended five years, over one generation.
Currently, there are two major bodies of literature that describe
characteristics and outcomes associated with the transitional
stage ranging from 18 through 25 years of age.
Characteristics Outcomes of
and
of the Cohort Populations
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6. The Cohort
Literature on emerging adulthood primarily uses a
developmental approach to theorize and describe the broad
characteristics of the 18 through 25 cohort
(Arnett, 2000).
Populations
The second body of research describe young adult
populations found within the emerging adult cohort by
comparing differencesbetween the outcomes of
populations (GAO, 2008).
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7. Investigating the Cohort
Using a Developmental Approach
The successful transition through emerging adulthood
is indicated by a positive trend
in the progressive achievement
of criteria (Kins&Beyers, 2010).
Marriage
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8. Serious Mental Illness
A population reported to experience significant differences in the
achievement of criteria, are young adults who experience symptoms
of serious mental illness (GAO, 2008; Gralinksi-Bakker, Hauser, Billings, Allen, Lyons,
Melton, 2005; Rosenberg, 2008).
In 2008 the U.S. Government Accountability Office reported that
2.4 million young adults (6.5%) experienced symptoms of
mental illness during the past year (GAO, 2008).
Literature on this population measures the impact of serious mental
illness on the developmental transition into adulthood by comparing
outcomes and observing trends between young adults and the general
emerging adult cohort (Gralinksi-Bakker, Hauser, Billings, Allen, Lyons, Melton, 2005).
Research has found that serious mental illness is highly
associated with negative outcomes for young adults (GAO, 2008).
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9. Outcomes
Lower educational achievement (Suvisaari, et. al., 2009):
•Significantly lower rates of high-school graduate
(19% difference) (GAO, 2008)
•Significantly lower rates of enrollment in postsecondary education
(19% difference) (GAO, 2008)
As well as:
•Higher rates of unemployment(Suvisaari, et. al., 2009)
•Higher rates of homelessness (GAO, 2008)
•Higher rates of unplanned pregnancies (GAO, 2008)
•Two times more likely to be involved in the juvenile or criminal
justice system (Manteuffel, Stephens, Sondheimer, & Fisher, 2000).
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10. Consistency in the Literature
Outcomes used within the clinical field to determine the
impact of serious mental illness mirror the developmental
Criteriawhich mark the transition to adulthood for the
general cohort.
Based on this relationship, the negative trend in
outcomes for young adults with serious mental illness
indicates that the criteria of adulthood is under-
achieved within this population.
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11. Services and Supports in
Connecticut
Agencies, Organizations, and Groups throughout
Connecticut offer specific programming that includes
services that are tailored to the unique developmental
needs of youth and young adults with mental health
and/or substance related disorders.
Think about how each of these programs have
helped you reach and maintain recovery.
Are services and supports addressing the intrinsic
needs that have been identified by the emerging
adult cohort to mark their transition into
adulthood?

12. Department of Mental Health and
Addiction Services
First put into practice in 1998, and is already found within 16
communities across Connecticut.
The DMHAS YAS program includes clinical, residential,
social recreational, vocational services, and life skills
development. These services are provided by trained
professionals using evidence-based approaches.
PROGRAMS USE A… Wrap-Around
Person-Centered
Recovery-Orientated
Comprehensive
Trauma Sensitive … APPROACH

13. Youth & Young Adult Programming
Active Minds of UCONN
Advocacy Unlimited Super Advocates Program
Birmingham Group Health Services
Bridges of Milford
Capitol Region Mental Health Center
Casey Family Services
Center for Human Development
Central Access & Student Development
Community Mental Health Affiliates
Community Health Resources
Connecticut Turning to Youth & Families
Continuum, Inc.
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14. Youth & Young Adult Programming
Focus on Recovery United
Greater Bridgeport Community Mental Health Center
Institute of Living
Prime Time House
River Valley Services
Rushford
Specialized Treatment for Early Psychosis (YALE)
South East Mental Health Authority
United Children & Family Services
United Services
Western Connecticut Mental Health Center – Torrington
Western Connecticut Mental Health Center – Waterbury
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15. Barriers to Recovery in Connecticut
In a recent qualitative study funded by the J. Walter Bissell
Foundation, NAMI-Connecticut identified four key barriers to
recovery experienced by youth and young adults across the
state:
• HOUSING: homelessness and supportive housing
restrictions for young people; along with
• EDUCATION: financial limitations that restrict young
people from continuing on to complete post secondary
education
• ACCESS: lack of tailored programming that is offered
within separate space or location that provides the
opportunity for young people to seek, achieve, and
maintain recovery among their peers.
• TRANSPORTION: themichaela.fissel@gmail.com transportation with
high cost of

16. Present Ecology of Need
The under-achievement of young adults with serious mental
illness suggests that mental health services are not effectively
meeting the unique needs of the cohort(GAO, 2008).
Consideration for the unique developmental transition of the
emerging adult cohort presents a class of variables that can be
targeted for early-intervention.
The need for tailored services has been acknowledged within
the literature since the beginning of community-based care
(Bachrach, 1984; Mercer-McFadden, Drake, Brown, & Fox, 1997),
and more recently the need for mental health services to reflect
the unique developmental criteria of the present cohort,
continues to be identified throughout the literature (GAO, 2008; Mercer-
McFadden, Drake, Brown, & Fox, 1997; Rosenburg, 2008).
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17. Help Take Connecticut to the Next Level!
It is undeniable that there are systematic barriers
engrained throughout the services and programs
currently offered to youth and young adults across
Connecticut.
These barriers limit a young person’s ability to
seek, achieve and maintain recovery.
WHAT CAN BE DONE TO
ELIMINATE THESE BARRIERS?
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18. • Working diligently as a leader within the
recovery community to make the possibility of
recovery available to every young person who
seeks it.
• Building a network of young people who
can lead advocacy across the state at the
local, regional, and state levels.
• Using our experiences to influence change
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