Troubled youth in transition: An evaluation of Connecticut's special services for individuals aging out of adolescent mental health programs

doi:10.1016/j.childyouth.2005.10.010

Children and Youth Services Review

Volume 28, Issue 9, September 2006, Pages 1088-1101

https://doi.org/10.1016/j.childyouth.2005.10.010 Get rights and content

Abstract

Like many areas of the United States, Connecticut has faced a pressing need for specialized services for young individuals with psychiatric disabilities who have been “aging out” of the child and/or adolescent mental health service system(s). Beginning in 1997, Connecticut began to address this need, in part, through implementation of a Young Adult Services (YAS) program, designed to provide young individuals with moderate to severe symptoms of mental illness with comprehensive services and supports. Recently, a multi-method evaluation of selected components of the YAS program was undertaken in order to provide descriptive information on client characteristics and psychological functioning; to identify program components related to positive client outcomes; and to present qualitative data on clients' experiences in the program and other relevant areas. Results of the evaluation suggest that the YAS program has achieved considerable success at meeting the complex needs of its clients, including assisting them with transitions to more independent living in the community. Among other significant findings is the importance of strengths- and community-focused treatment components to successful outcomes. Strengths- and community-focused components were found to be associated with fewer symptoms, less loneliness, fewer reported problems, higher functioning, and greater satisfaction with services. The presence of community-focused treatment planning also offered a significant contribution to fewer arrests among this sample of YAS clients. In addition, longer program tenure was a significant predictor of greater satisfaction with services and higher quality of life. These findings and their implications for program development targeting the needs of young adults with psychiatric disabilities are discussed.

Introduction

“I've never been on my own and I didn't know what to do. People usually told me what to do.” —Young Adult Services client

Like many of its sister state agencies across the country, the state of Connecticut's Department of Mental Health and Addiction Services (DMHAS) has faced a pressing need for specialized services and supports among young individuals with psychiatric disabilities who have been “aging out” of (i.e., becoming too old to receive services within) the child and/or adolescent mental health service system(s). Beginning in 1997, DMHAS began to address this need through implementation of a Young Adult Services (YAS) program, designed to assist young adults (18 or older) with moderate to severe symptoms of mental illness in need of developmentally appropriate clinical, residential, vocational, social rehabilitation, and/or case management services. Many of these youth had spent their earlier years living in supervised residential or treatment programs, or had experienced long periods of foster care. In addition to providing needed treatment and rehabilitation services to this population, a major challenge of the YAS program has been to facilitate the young adults' transition from highly supervised and structured residential programs into community settings where they have a considerably higher degree of freedom and autonomy.

Recently, a multi-method evaluation to assess the effectiveness of YAS services in producing desired outcomes across a variety of life domains was undertaken. This evaluation generated information about characteristics of this population, service delivery and clients' perspectives on their experiences before and since entering the YAS program. To contribute to a growing literature that can be used to guide the development of specialized services and supports for young adults with psychiatric disabilities, we offer the following selected outcome data from this evaluation.

Section snippets

Program description

The YAS program was developed by the State of Connecticut's Department of Mental Health and Addiction Services (DMHAS) to serve youth with high-risk behaviors who were “aging out” of the state child welfare/protective service system. The first cohort of clients for what was to become the YAS program consisted of young adults with a history of psychosexual behavior problems. Many of these young people had been committed to Connecticut's Department of Children and Families (DCF) and subsequently

Sample and procedures

Participants in the evaluation were young adults randomly selected from among all of those served in YAS at the six program sites in Connecticut. Eligible clients were enrolled in YAS and were 18 years of age or older. Eligible clients were placed in a random order by the Clinical Director of YAS and were invited by their clinicians or program directors to learn more about the proposed study from research staff. Interested clients met with research staff to learn more about the study and to

Sample characteristics

The average age for the sample was 20.43 years (S.D. = 3.36). 78% of the sample was male (n = 47). The racial background of the participants was: Caucasian (55%, n = 33), African-American (15%, n = 9), Hispanic (23%, n = 14), American Indian (2%, n = 1), and Asian (3%, n = 2). Participants had been in the program for an average of 20.25 months (S.D. = 12.56, median = 17.63). 62% of the sample had a history of a sexual offense (n = 37). On average, participants were incarcerated for a lifetime average of 28.31 days

Discussion

In this paper, we have sought to present a broad variety of descriptive, outcome and qualitative data related to the evaluation of an innovative program for young adults with psychiatric disabilities in the State of Connecticut. It is our hope that this data will prove useful to organizations who are currently providing or may be planning to provide care to young adults aging out of foster care or other institutional settings and for those conducting or with an interest in research with

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Troubled youth in transition: An evaluation of Connecticut's special services for individuals aging out of adolescent mental health programs

Abstract

Introduction

Section snippets

Program description

Sample and procedures

Sample characteristics

Discussion

Personality and Individual Differences

Attachments beyond infancy

American Psychologist

An ethological approach to personality development

American Psychologist

Complex posttraumatic stress disorder in women from a psychometric perspective

Journal of Personality Assessment

Attachment styles among young adults: a test of a four-category model

Journal of Personality and Social Psychology

Childhood Trauma Questionnaire: A retrospective self-report manual

Initial Reliability and validity of a new retrospective measure of child abuse and neglect

American Journal of Psychiatry

SCL-90: Symptom Checklist-90–Revised: Administration, scoring, and procedures manual

The structure, stability and correlations of the trait components of conduct disorder, attention deficit and anxiety/withdrawal reports

Journal of Child Psychology and Psychiatry