Mental health and health care utilization among transition age youth

Abstract

Many individuals experience mental health problems during the transition from adolescence to adulthood. For most persons, this experience is a temporary departure from otherwise good mental health. However, persistent mental health problems during young adulthood have serious implications for the life course, as such problems can interfere with educational, employment and social opportunities. There has been little research that examines the persistence of mental health problems during young adulthood, and limited research using multiple dimensions of mental health (rather than one specific condition). And further, little is known about the extent to which young adults with mental health problems use mental health care and other medical care. This study used nationally representative household survey data spanning a two-year period and latent class models to identify transition age youth (age 18 to 27) with persistent mental health problems, to identify their patterns of mental health and other medical care use, and to examine the socio-demographic and physical health correlates of poor mental health and health care use. Results indicated that about twelve percent of young adults have persistent mental health problems. But about half of these young adults rated their mental health as good, and this group was less likely to be in poverty, had fewer physical health problems, and used less health care overall compared to those with persistent problems and poor self-rated mental health (severe persistent problems). Two in five young adults with severe persistent mental health problems did not receive mental health care during the study period; however, nearly ninety percent of these young adults received other medical care, suggesting stronger integration of mental and physical health care is needed. Among young adults with persistent severe problems, those who were uninsured, poor, and Black or Hispanic were substantially less likely to use mental health care, compared to their insured, wealthier, and White counterparts. Removing barriers to mental health care could reduce disparities in well-being between social groups during the transition to adulthood, and potentially in life course outcomes.