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Support the Transition to Adulthood



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Policy Considerations to Support the Transition to Adulthood Maryann Davis Transitions RTC Center for Mental Health Services Research Department of Psychiatry University of Massachusetts Medical School Why Change Policies Typical Services Poor Outcomes of Subjects General Population 100 90 80 70 60 50 40 30 20 10 0 SMHC Finish High Employed Homeless Pregnant Mental General Mental General Mental General Mental General School Health Health Health Health Valdes et al 1990 Wagner et al 1991 Wagner et al 1992 Wagner et al 1993 Kutash et al 1995 Silver et al 1992 Vander Stoep 1992 Vander Stoep and Taub 1994 Vander Stoep et al 1994 Vander Stoep et al in press Davis Vander Stoep 1997 Arrest Rates are High Males MH Males GenPop Females MH Females GenPop 0 8 Proportion of Subjects 0 7 0 6 0 5 0 4 0 3 0 2 0 1 0 No Arrests Single Arrests Number of Arrests by Age 25 Multiple Arrests Comorbidity with Substance Abuse Dependence Percent of Total NACTS Drug or Alcohol Marijuanna Alcohol 50 40 30 20 10 0 8 18yrs 17 21yrs 21 25yrs Greenbaum personal communication in Davis Vander Stoep 1997 Young Adults Struggle More than Mature Adults 60 of Respondents 18 30 yr olds 55 35 54 yr olds 50 40 33 33 29 5 30 20 24 2 21 8 18 3 18 3 8 9 10 2 0 Not Below Working Poverty In School Daily Friend Area of Functioning 2 df 1 31 4 105 4 p 001 2 df 1 5 5 p 02 Not Married Typical Services are Not Effective Why not just change services Examples of the impact of policy on practice You have to end your treatment because your client is turning 18 and your clinic s license is for children only You want to arrange a meeting between the 20 year old client you ve worked with as a case manager for 4 years you and his new adult case manager so you can foster a good connection between them but the CM can t meet with the two of you because it would be double billing on case management services All the young adults who enter your program don t know the very basics about arranging appointments or following through



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