Project Seeks Replicable Service Model For Youth In Transition
Mental Health Weekly August 31st 2009

Although some effective service models have emerged to help youths with significant mental health needs as they negotiate the difficult transition to young adulthood, little has been accomplished in applying these models across the public service system. The National Council for Community Behavioral Healthcare and a Detroit community mental health organization are partnering on a project designed to determine which elements of an effective service model could be sustained in the public-sector organizations accustomed to serving these young people.

The National Council has selected Southwest Counseling Solutions, which serves the most culturally diverse region of Detroit, to participate in the three-year Transition Age Youth Project. Under the effort, funded by a $731,000 grant from the Bristol-Myers Squibb Foundation, Southwest Counseling will provide clinical services as well as mentoring and coaching to 40 young people in order to help them develop a number of important life skills. Behavioral health consulting organization MTM Services is also a partner in the project.

Because the project will focus not on a transition to the adult mental health system but on a transition to adulthood in general, it is not  assumed that all of the participating youths will need adult mental health treatment as they exit the child services system. But it is also not assumed that they won’t need adult treatment.

“We’re not just walking adolescents to the adult system,” Christopher Loftis, Ph.D., the National Council’s director of practice improvement, told MHW. “We’re helping them achieve recovery, and independence.”

Young people ages 18 to 26 who have been in the children’s mental health system experience a serious risk of having the transitional years become a period of lost time, often exacerbated by a lack of continuity between the child and adult-serving systems in their com-munities. A written outline of the Transition Age Youth Project states that while most people in this age group share the same life goals, “for the more than 3 million young adults diagnosed with serious mental health conditions, the road is even more challenging, and for those who reside in residential treatment facilities or foster homes, turning 21 can feel like falling off a cliff.”

Federal data illustrate the missed opportunities that halt the progress of many of these young people. According to a 2008 Government Accountability Office (GAO) report, the 2.4 million young people ages 18 to 26 with serious mental illnesses are less likely than their peers to graduate from high school (64 percent vs. 83 percent) or enter college (32 percent vs. 51 percent). These young people also have difficulty in developing work skills, and in accessing appropriate general and mental health care.

“In these young people with serious emotional disturbances, we’ve seen a lot of conduct disorders and a lot of ADHD, and these diagnoses don’t translate well into adulthood and the adult service system,” Carlynn Nichols, program director at Southwest Counseling Solutions, told MHW. “Having ADHD doesn’t make you eligible for adult services in our community.”

But as an agency with extensive experience in both the children’s and adult mental health systems, Southwest Counseling has traditionally focused on this transition period and has become skilled in bringing together the various systems that can effectively coordinate services for this group, from foster care to job training.

“We’ve done a nice job of engaging partners,” agency executive director Joseph Tardella told MHW, citing a factor that he believes was instrumental in the National Council’s selection of his agency among a group of 40 applicants for the grant-funded project.

Service Model
The service models that have emerged for transition-age youths acknowledge that young people with mental health needs require multi-pronged strategies that emphasize community integration, encompassing a range of life, work and social skills.

According to the National Council project outline, one of the most empirically supported models is the Transition to Independence Process Model developed by Rusty Clark and colleagues at the Louis de la Parte Florida Mental Health Institute. The model employs “transition facilitators” who act as mentors and work with young people and their families to help improve outcomes in the areas of employment, education, living situation, quality of life and community life functioning.

Southwest Counseling will incorporate important components of the Transition to Independence Process Model, with an eye toward determining whether certain elements are replicable across the public service system despite its resource constraints. The 40 individuals to be served in the grant-funded program will receive a variety of services, including:
• Transitional mentoring and coaching in the two implementation years of the three year project, helping the young people make sound decisions as they proceed into adulthood. These services will be integrated with the behavioral health care services offered by the community based agency.
• Links to supported employment, vocational training, work experiences and work ethic training.
• Access to tutoring and other educational supports.
• Social skills training, encompassing areas such as problem solving, assertiveness, conflict resolution and harmonious relations with peers and family members.
• Other life skills, including communication skills and insight into personal strengths and weaknesses.

“When youth reach the ages after 16 and 17, they look to their future; they’re doing all the things adolescents do, but some are doing them with mental health conditions,” Tardella said. “Our model focuses on independence, and is based on kids’ strengths and interests.”

The project outline states that Southwest Counseling not only will receive intensive consultation geared toward helping it meet program objectives, but also will have access to specialized strategies that it can apply after the grant project ends. Data collected from the project will help determine the sustainability of the effort targeting youths  in transition, both for Southwest Counseling and for other public mental health agencies that serve these young people.