Page Title

Facts on Transitional Services for Youth with Mental Illnesses

Providing comprehensive support services to youth with mental illnesses
transition into adulthood is critical to their success. Many youth age out of
children’s services without any transitional planning and lack skills necessary to
manage their illnesses and accomplish their goals. These youth face the
challenge of entering adulthood without proper services and support.

Prevalence

•        More than 3 million transition age youth have been diagnosed with a Serious
Mental Illness.[1]
Adolescents that transition into adulthood with a Serious Mental Illness are three
times more likely to be involved in criminal activity than adolescents without an
illness.[2]
Incarcerated youth age 18-22 are more likely to have a mental illness than younger
adolescents in the juvenile justice system.[3]
Transitional age youth with a Serious Mental Illness have higher rates of
substance abuse than any other age groups with mental illness.[4]
Rates of Serious Mental Illness are highest among young adults age 18, and rates
decrease for each year thereafter.[5]
Unmet Needs and Consequences
Education and Employment. Young adults with a Serious Mental Illness face many
challenges when transition from school to adulthood.[6] Over 60 percent of
young adults with a Serious Mental Illness are unable to complete high school.
These young adults are often unemployed, unable to participate in continuing
education, and lack successful skills necessary for independent living.[7]
Increased Risk of Suicide. An estimated 20 percent of youth receiving treatment
for emotional or behavioral problems have either contemplated suicide or
attempted suicide.[8] Less than 40 percent of youth at risk of suicide receive
treatment.[9] Suicide is the third leading cause of death among young adults age
15 to 24.[10]

Effective Services

Individualized Services. Youth in transition need services that assist them in
employment, housing, and education. Research shows that these services are
most effective when they are tailored to meet the goals of each young person.
Services and supports also need to be developmentally appropriate in order to
build on the strengths of youth in transition.[11]
Personal Responsibility and Parental Support. Services are most effective when
youth are able to develop problem-solving skills and learn to experience
consequences through their decisions. Parental involvement is key in
guaranteeing that youth have a safety net of support.[12]
Barriers to Meeting Needs
Gaps in Services. No system or agency is responsible for youth with mental illness
transition into adulthood. Youth with mental illness may be involved with service
systems such as special education, child welfare, and juvenile justice. When
these youth age out of their respective youth system they are often ignored or
neglected in the transition period to adulthood.[13]
Under Utilization of Services. Many adolescents and youth in transition do not
receive specialty services despite the availability of services. This is often due to
the stigma associated with mental illness and mental health services.
Furthermore, cost of services and dissatisfaction with services prevent youth
from receiving treatment.[14]
Lack of Support. Many transitional youth lack the personal connections and
friendships necessary for successfully managing their illness. Transitional youth
are often separated from their families and do not receive adequate support.[15]

Youths with mental health disorders are ending up in the juvenile
justice system, and many are not being treated properly. The
mental health needs of America's youths must be taken seriously
in order to prevent delinquent behavior and to successfully treat
young offenders so they are less likely to re-offend.

Between 50 and 75 percent of incarcerated juveniles have diagnosable mental
health disorders, compared to 20 percent of children and teens in the general
population.
According to a survey conducted by the National Association for the Mentally Ill,
36 percent of parents said their children were in the juvenile justice system
because mental health services outside of the system were unavailable to them.
At least half of incarcerated youths with mental health disorders have co-
occurring substance abuse disorders, making their diagnosis and treatment
needs more challenging.
Up to 19 percent of incarcerated youths may be suicidal. Youth suicide in juvenile
detention and correctional facilities occurs four times more often than youth
suicide in the general public.
Many youths with mental health needs also have additional underlying issues,
including physical abuse, sexual abuse, parental drug or alcohol use, poor school
performance or truancy, family disorder, and learning disabilities.
Females in the juvenile justice system are shown to have higher rates of mental
health disorders than their male counterparts.
Many minority children with mental health needs entering the juvenile justice
system have either not been treated or have been insufficiently served by
systems in the community.
Black youths (particularly males) are more likely to be referred to the juvenile
justice system than a treatment system.
Black juvenile offenders are less likely than their White counterparts to have
previously received mental health services.
Mexican-Americans and other immigrant groups have shown less use of mental
health services, due in part to poor English-language comprehension and lack of
community-based services.
In contrast, 28 percent to 46 percent of the juvenile offender population have an
educational disability. Of that group, 9 percent to 42 percent are LD, 16 percent to
50 percent are SED, and 3 percent to 30 percent are MR.
Of incarcerated juvenile offenders, 28 percent to 60 percent have an educational
disability. Of those youths, 11 percent are LD, 20 percent are SED, 18 percent are
ADD/ADHD, and 3 percent to 10 percent are MR.
Most incarcerated youths lag two or more years behind their peers in basic
academic skills. More than one-third at the median age of 15 read below the
fourth-grade level.
Youths with educational disabilities are 200 percent more likely to be arrested
than non-disabled youths for comparable delinquent activity.
Despite similar records of prior offenses, once adjudicated, the terms of
incarceration and/or probation averaged two to three years longer for those with
disabilities as compared to their non-disabled peers.
dependent, or have fathers who are in jail or nowhere to be found. These youth
were abused, neglected or abandoned>to the point where caring professionals
realized that they would never be able to count on living with their families of
origin for any extended period of time. We have to focus our energies on helping
youth build workable futures for themselves.

Suicide is the third leading cause of death among teens and young adults. In 2000,
3,994 teens and young adults ages 15 - 24 committed suicide---one every 2 hours
and 12 minutes. 73
Seven out of 10 cases of child abuse or neglect are exacerbated by a parent's
abuse of alcohol or other drugs

Recommendations

Policy makers can promote improved treatment by:
Creating a comprehensive service system for youth in transition that extends
services between adolescence and adulthood.
Encouraging the adult mental health system to develop programs and services for
young adults age 19-25.
Ensure continued Medicaid eligibility through age 24 for youth on SSI at age 18.
Providing funding to SAMHSA in order to increase technical assistance, research,
and demonstration projects to develop proven services specifically designed for
transitional youth.

More than 1 million parents were incarcerated in prisons or local jails in 2000,
affecting 2.3 million children. 91
MENU TITLE: Providing Services for Jail Inmates With Mental Disorders.
Series: NIJ Research in Brief
Published: January 1997
22 pages
44,730 bytes

U.S. Department of Justice
Office of Justice Programs
National Institute of Justice

Notes

[1] Vander Stoep A., Beresford S., Weiss N., McKnight B., Cauce M., and Cohen P., (2000). Community-based Study of
the Transition to Adulthood for Adolescents with Psychiatric Disorders. American Journal of Epidemiology, 152, no4,
352-362
[2] Vander Stoep, A., Beresford S., Weiss N., McKnight B., Cauce M., and Cohen P., (2000). Community-based Study of
the Transition to Adulthood for Adolescents with Psychiatric Disorders. American Journal of Epidemiology, 152, no4,
352-362
[3] Teplin L., (1994). Psychiatric and Substance Abuse Disorders among male urban jail detainees. American Journal
of Public Health, 84, 290-293.
[4] U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General-- Children and
Mental Health. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health
Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental
Health, 1999.
[5] U.S. Department of Health and Human Services. (2001). Results from the 2001 National Survey on Drug Use and
Health: Prevalence and Treatment of Mental Health Problems. U.S. Department of Health and Human Services,
Substance Abuse and Mental Health Services Administration.
[6] Carson, R., Sitlington, P., and Frank, A., (1995). Young Adulthood for Individuals with Behavioral Disorders: What
Does it Hold? Behavioral Disorders, 20, 127-135
[7] Hagner, D., Cheney, D., and Malloy J., (1999). Career Related Outcomes of a Model Transition Demonstration for
Young Adults with Emotional Disturbance, Rehabilitation Counseling Bulletin, March, Vol 42, 3.
[8] U.S. Department of Health and Human Services (2002). Results from the 2002 National Survey on Drug Use and
Health. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.
a
[9] U.S. Department of Health and Human Services (2002). The National Household Survey on Drug Abuse Report. U.S.
Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.
[10] Miniño AM, Arias E, Kochanek KD, Murphy SL, Smith BL. Deaths: final data for 2000. National Vital Statistics
Reports, 50(15). Hyattsville, MD: National Center for Health Statistics, 2002.
[11] Clark, H., (2003). Transition to Independence Process Definition and Guidelines, TIP System and Development and
Operations Manual, University of South Florida.
[12] Clark, H., (2003). Transition to Independence Process Definition and Guidelines, TIP System and Development and
Operations Manual, University of South Florida.
[13] Davis M., and Vander Stoep A., (1997). The Transition to Adulthood for Youth Who Have Serious Emotional
Disturbance: Developmental Transition and Young Adult Outcomes, The Journal of Mental Health Administration, 24:4.
[14] U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General-- Children and
Mental Health. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health
Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental
Health, 1999.
[15] Davis M., and Vander Stoep A., The Transition to Adulthood among Adolescents Who have Serious Emotional
Disturbance. Delmar, NY: The National Resource Center on Homelessness and Mental Illness Policy Research
Associates, Inc., 1996.

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