Mental Health and Transition Planning

Mental Health and Transition Planning

Annotated Bibliography

Prepared for NSTTAC by Jennifer Cease-Cook

Research has established a clear picture of the real-life outcomes of transition-age individuals with disabilities. For example, the National Longitudinal Transition Study 2 reports that young adults with disabilities are employed at a rate lower than their same-age peers without disabilities (i.e., 57% of individuals with disabilities were employed compared to 66% of youth without disabilities; Newman, Wagner, Cameto, & Knokey, 2009; Wagner et al., 2005; Newman et al., in press). Although progress has been made to improve outcomes, individuals who use mental health services face even more challenges during their transition. The mental health field has recognized the service gaps and challenges that individuals with disabilities face in the transition from child to adult services, (Clark, Koroloff, Geller, & Sondheimer, 2008) but limited research has been done to help clarify how to support this transition and adapt services to the meet the needs of these individuals. As a result, the purpose of this annotated bibliography is to summarize articles for individuals, educators, families, and other service providers on topics associated with transition planning and young adult services for youth receiving, and in need of, mental health services. The resources in the annotated bibliography are organized into the categories of (a) service status and (b) service recommendations for transition-age youth with mental health service needs.

References

Clark, H.B., Koroloff, N., Geller, J., & Sondheimer, D.L. (2008). Research in transition to adulthood: Building the evidence base to inform services and support for youth and young adults with serious mental health disorders. Journal of Behavioral Health Services and Research, 35, 365-372.

Newman, L., Wagner, M., Cameto, R., & Knokey, A.M. (2009). The post-high school outcomes of youth with disabilities up to 4 years after high school. A report of findings from the national longitudinal transition study-2 (NLTS2) (NCSER 2009-3017). Menlo Park, CA: SRI International. Available at www.nlts2.org/reports/2009_04/nlts2_report_2009_04_complete.pdf.

Newman, L., Wagner, M., Knokey, A.M., Marder, C., Nagle, K., Shaver, D., . . . Schwarting, M. (in press). The post-high school outcomes of young adults with disabilities up to 8 years after high school. A report from the National Longitudinal Transition Study-2 (NLTS-2) (NCSER 2011-2005). Menlo Park, CA: SRI International.

Wagner, M., Newman, L., Cameto, R., Garza, N., & Levine, P. (2005). After high school: A first look at the postschool experiences of youth with disabilities. A report from the National Longitudinal Transition Study-2 (NLTS2). Menlo Park, CA: SRI International.

Status of Services

Chapin, E., O’Hara, J., Holt, G., & Bouras, N. (2009). Mental health services for people with intellectual disability: Challenges to care delivery. British Journal of Learning Disabilities, 37, 157-164.

• Discussed the inequalities in accessing mental health services in London for people with intellectual disability
• Reports the advances in mental health care in the last 25 years and the service gaps for people with intellectual disability
• Discussed Green Light tool kit as a resource. It is a self-assessment tool designed to identify deficits and state where services are expected, and used, as a standards check for mental health services

Davis, M., Geller, J., & Hunt, B. (2006). Within-state availability of transition-to-adulthood services for youths with serious mental health conditions. Psychiatric Services, 57, 1594-1599.

• Reports the status of services within state child and adult mental health systems that support the transition from youth to adulthood
• Analyzed data from 41 states and the District of Columbia
• Findings indicate 25% of child state mental health systems and 50% of adult state mental health systems offered no transition services
• Most types of transition services were available in fewer than 20% of all states analyzed

Davis, M., & Sondheimer, D.L. (2005). Child mental health systems’ effort to support youth in transition to adulthood. Journal of Behavioral Health Services and Research, 32, 27-42.

• Reports status of services for child mental health systems from interviews with members of the Children, Youth, and Families Division of the National Association of State Mental Health Program Directors (NASMHPD)
• Reported transition services within the mental health services are sparse nationally
• Recommended approaches that can enhance funding such as: (a) take advantage of opportunism; (b) start small; (c) blend or combine funding with other agencies that share concern and population, such as child welfare independent living programming for adolescents involved in both systems or adult mental health targeted at adolescents who will enter adult services; (d) if there are preexisting interagency child-funding efforts, work toward adult agencies and focusing on a shared populations; (e) join with partners advocating for increased funding from potential sources, such as legislatures and federal entities; and (f) analyze any untapped resources for transition support

Davies, J. & Giraud-Saunders, A. (2006). Support and services for young people with learning disabilities and mental health problems. The Mental Health Review, 11, (3), 8-15.

• Reviews current mental health service needs of adolescents in England
• History of service provision and barriers to access are discussed
• Priorities addressed in projects funded by England’s Department of Education and Skills or Department of Health include (a) early support programming, (b) person-centered planning, (c) workforce development, and (d) transition guidance.

Ellison, M.L., Danley, K.S., Bromberg, C., & Palmer-Erbs, V. (1999).  Longitudinal outcomes of young adults who participated in psychiatric vocational rehabilitation program. Psychiatric Rehabilitation Journal, 22, 337-341.

• Reports the longitudinal outcomes of participation in a psychiatric rehabilitation program for young adults up to nine years after the program ended
• Findings include positive effects in (a) gains in vocational status, (b) self-esteem scores, and (c) reduction in hospitalization rates.
• Findings also reported a higher number of people working

Fier, S.M., & Brzezinski, L.G. (2010). Facilitating the high school-to-college transition for students with psychiatric disabilities: Information and strategies for school counselors. Journal of School Counseling, 8, 1-40.

• Discusses the academic and personal challenges these students face in college
• Provides transition tools for school counselors

Heflinger, C.A., & Hoffman, C. (2008). Transition age youth in publicly funded systems: Identifying high-risk youth for policy planning and improved service delivery. The Journal of Behavioral Health Services and Research, 35, 390-401.

• Reports an analysis of Medicaid enrollment indicated youth with high-risk of transition difficulties were identified into groups
• Findings include: (a) serious emotional disability (SED); (b) state custody/foster care;(c) users of intensive or frequent mental health services;or (d) having diagnoses of mental disorders, conduct disorders, or developmental disabilities
• Of the 23% of students identified as being in one or more of these high-risk groups, over 75% of the youth identified as high-risk met the criteria for SED

Kaehne, A. (2011). Transition from children and adolescent to adult mental health services for young people with intellectual disabilities: A scoping study of service organisation problems. Advances in Mental Health and Intellectual Disabilities, 5, 9-16.

• Reports results of  interviews with mental health professionals in Wales to identify potential research themes in the area of transition and mental health services
• Three themes that emerged from the data were (a) coordination of services, (b) concerns about existing service gaps, and (c) differences in service models and service approaches between child and adult services

Pottick, K.J., Bilder, S., Stoep, A.V., Warner, L.A., & Alvarez, M.F. (2008). US patterns of mental health service utilization for transition-age youth and young adults. The Journal of Behavioral Health Services and Research, 35, 373-388.

• Reviews Client/Patient Sample Survey and U.S. Census data to document service use trends for persons of transition age for inpatient, outpatient, and residential treatment services
• One finding showed a decline of mental health services use between the ages of 17-18 years old, despite the rise in mental health diagnosis for those in the early 20’s.
• Findings supported the hypothesis that residential treatment programs are the least likely to offer seamless services

Pullman, M.D., Heflinger, C.A., Mayberry, L.S. (2010). Patterns of Medicaid disenrollment for youth with mental health problems. Medical Care Research and Review, 67, 657-675.

• Reports a longitudinal study examining the Medicaid enrollment period for 6,471 people with disabilities
• Results showed gender was a major predictor in loss of Medicaid and reaching age of majority resulted in a loss of eligibility
• Authors suggested policies for automatic ineligibility and disenrollment from Medicaid as a function of age need to be recognized

Unwin, G., LeMesurier, N., Bathia, N., & Deb, S. (2008) Transition for adolescents and young adults with learning disabilities and mental health problems/challenging behaviours: The parent carer’s views. Advances in Mental Health and Learning Disabilities, 2, 22-28.

• Presents parent caregivers’ views for young people with intellectual disabilities and additional mental health problems in transition
• Overall concerns included (a) losing specialist involvement during transition, (b) services are not attuned to individuals with intellectual disabilities, and (c) gap between expectation and service provision

Recommendations for Services

Adelman, H.S., & Taylor, L. (1998). Reframing mental health in schools and expanding school

            reform. Educational Psychologist, 33,135-152.

• Discusses that school systems use a variety of personnel to address mental health services. These support services include: (a) direct services and instruction; (b) coordination, development, and leadership related to programs, services, resources, and systems; and (c) enhancement of connections with community resources
• Discusses that mental health services are given a low policy priority and that little has been done at any administrative level
• Recommends addressing barriers to development, learning, and teaching. It is called “A continuum of five fundamental areas for analyzing policy and practice.” Those five areas include: (a) measures to abate economic inequities and restricted opportunities; (b) primary prevention and early age interventions; (c) identification and amelioration of learning, behavior, emotional, and health problems as early as feasible; (d) ongoing amelioration of mild-moderate learning, behavior, emotional, and health problems, and (e) ongoing treatment and support for chronic and severe disabilities

Davis, M. (2003). Addressing the needs of youth in transition to adulthood. Administration and Policy in Mental Health. 30, 495-509.

• Discusses recommendation for action based on two national work groups (NASMHPD and Center for Mental Health Services (CMHS)
• Those recommendations include (a) take responsibility, (b) leadership and advocacy, (c) emphasize and strengthen natural supports, and (d) increase funding

Jivanlee, P. & Kruzich, J. (2011). Supports for young people with mental health conditions and their families in the transition years: Youth and family voices. Best Practices in Mental Health, 7, 115-133.

• Reports a qualitative study with 16 students with mental health conditions and 18 of their parents
• Summarizes family and youth preferences and frustrations regarding services
• Recommends family supports include (a) peer support and leadership groups, (b) accessible and appropriate services, and (c) responsive and compassionate service providers

Osgood, D.W., Foster, E.M., & Courtney, M.E. (2010). Vulnerable populations and the transition to adulthood. The Future of Children, 20, 209-228.

• Investigates transitions for youth involved in mental health system, foster care, juvenile justice, criminal justice, special education, runaway, and homeless
• Identifies barriers in public policies directed at the vulnerable youth including (a) eligibility criteria that exclude youth from services, (b) inadequate funding, (c) a lack of coordination of service across systems, and (d) inadequate training for service professionals
• Discusses policy options that can help create a more inclusive system of support such as (a)  strengthening all programs by improving the existing systems, (b) addressing the loss of access to services at the age of majority, and (c) coordinating multiple systems into a single coherent one

Price, L.A., Johnson, J.M., & Evelo, S. (1994). When academic assistance is not enough: Addressing the mental health issues of adolescents and adults with learning disabilities. Journal of Learning Disabilities, 27, 82-90.

• Discusses the important steps and examples of interventions from the University of Minnesota: The Learning Disabilities Transition Project and Project Extra using case study examples
• Describes the theoretical models for mental health services that address psychosocial issues frequently occurring in academic and vocational settings

Rones, M., & Hoagwood, K. (2000). School-based mental health services: A research review.

            Clinical Child and Family Psychology Review, 3,223-241.

• Reviews randomized, quasi-experimental, or multiple baseline research designs
• Results showed there are strong school-based mental health programs that have evidence of impact across a range of emotional and behavioral disabilities
• Discusses the important features of successful programs including: (a) consistent program implementation;(b) inclusion of parents, teachers or peers; (c) use of multiple modalities; (d) integration of program content into general classroom curriculum; and (e) developmentally appropriate program components

Wagner, M., Friend, M., Bursuck, W., Kutash, K., Duchnowski, A.J., Sumi, W., & Epstein, M. (2006). Educating students with emotional disturbances: A national perspective on school programs and services. Journal of Emotional and Behavioral Disorders, 14, 12-30.

• Provides analysis of national data from Special Education Elementary Longitudinal Study and the National Longitudinal Study-2
• Results indicated students with emotional disturbance (ED) who received special education services: (a) attend larger schools with higher special education populations; (b) are included in general education less often and the general education teachers feel less prepared to work with them; and (c) are likely to receive accommodations, but not likely to receive academic supports such as tutoring
• Mental health and family support services are not commonly provided
• Recommendations are made for collaborating with mental health professionals and a more integrated approach

Other Relevant Sources

Psychiatric Rehabilitation Journal (Winter 2012) This Special Issue addresses Young Adults with Mental Health Challenges. For more information see: http://prj.metapress.com/app/home/contribution.asp?referrer=parent&backto=issue,1,15;journal,1,39;linkingpublicationresults,1:119989,1

Advances in Mental Health and Intellectual Disabilities

(formerly Advances in Mental Health and Learning Disabilities) Advances in Mental Health and Intellectual Disabilities is the a professional journal specific to the mental health needs of people with intellectual/learning disabilities. Articles include: current research, policy and its implications for practice, developments in service design and delivery, news and resource reviews, and clinical case studies. For more information visit: http://www.emeraldinsight.com/products/journals/journals.htm?id=amhid

The United States Government Accountability Office (GAO; 2008) investigated what states and federal agencies are doing to take steps to address transition challenges with young adults with serious mental illness. When the transition to adulthood is unsuccessful, economic hardship, social isolation, and suicide can occur. All of these outcomes pose substantial costs to society.

• Summarizes information on (a) number of these young adults including demographic data, (b) challenges they face, (c) how states assist them, (d) how the federal government supports states in serving these young adults and coordinates programs that can assist
• To view the report, see: http://www.gao.gov/new.items/d08678.pdf

Books

Clark, H., & Davis, M. (Eds.).(2000). Transition to Adulthood: A Resources for Assisting Young People with Emotional and Behavioral Difficulties. Baltimore: Paul H. Brookes, Co.

Clark, H.B., & Unruh, D.K. (2009). Transition of Youth and Young Adults with Emotional or Behavioral Difficulties: An Evidence-Based Handbook. Baltimore: Paul H. Brookes, Co.

This document was produced under U.S. Department of Education, Office of Special Education Programs Grant No.  H326J110001.  Marlene Simon-Burroughs served as the project officer.  The views expressed herein do not necessarily represent the positions or polices of the Department of Education.  No official endorsement by the U.S. Department of Education of any product, commodity, service or enterprise mentioned in this publication is intended or should be inferred.  This product is public domain.  Authorization to reproduce it in whole or in part is granted.  While permission to reprint this publication is not necessary, the citation should be: National Secondary Transition Technical Assistance Center (2012). Mental Health and Transition Planning Annotated Bibliography, Charlotte, NC, NSTTAC.