Serious Health Conditions Research Articles

Young adults’ perceptions of adverse childhood experiences as context and causes of mental health conditions: Observations from the United States

BackgroundThe relationship between adverse childhood experiences (ACEs) and mental health later in life has been well-established. However, first-person qualitative narratives describing how ACEs negatively impact mental health of young adults are rare. ObjectiveQualitative data explores how young adults with serious mental health conditions (SMHC) describe childhood adversities and relate those experiences to their mental health conditions. Participants and settingYoung adult participants (n = 55; ages 25–30) who self-reported being diagnosed with an SMHC were recruited from one state in United States. In-person interviews were conducted to gather narratives related to mental health, education, training, and employment. MethodsYoung adults with lived experience actively participated in the research process. Iterative coding and thematic analysis were employed to assess ACEs reported and analyze how participants described those experiences as influential. ResultsMost participants identified as White, non-Hispanic women. Major depression and anxiety disorders were the most prevalent diagnoses. Over 80% reported experiencing trauma, familial mental illness, or substance use challenges. Young adults connected their ACEs to fear and anxiety, emotional processing difficulties, poor coping behaviors, delayed help-seeking, and later negative interpersonal relationships. ConclusionsThis study is the first to qualitatively describe how young adults with SMHC describe ACEs and relate those experiences to their own mental health conditions. Future research should seek similar first-hand accounts in vulnerable populations and consider the unique impact of the COVID-19 pandemic. Findings and future research can inform policy, practice, and mental health treatment for young adults who have experienced ACEs, especially in the post-pandemic era.

Work is the best medicine: A qualitative analysis of posttraumatic stress disorder and supported employment

AbstractCo‐occurring posttraumatic stress disorder (PTSD) negatively impacts employment outcomes for individuals with serious mental health conditions (SMHCs). This study examined how employment might help individuals manage PTSD. Sixty‐eight employed individuals with SMHCs and co‐occurring PTSD responded to two open‐ended questions focused on how work impacted the management of PTSD symptoms and their perceived need for support from a job coach. Findings revealed themes about benefits of work on PTSD symptom management and types of provider support desired. Study implications are discussed.

Factors that Influence the Continuous Pursuit of Education, Training, and Employment among Young Adults with Serious Mental Health Conditions

Young adults (ages 18–30) with serious mental health conditions (SMHC) often face challenges in their education, training, and employment pursuits. The study presented in this brief study describes young adult patterns of education, training, and employment activities for individuals with SMHC in the United States and identifies modifiable factors that hinder or facilitate their ability to consistently pursue these activities. Based on first-person narratives from young adults (ages 25–30) with SMHC, these findings should inform psychiatric rehabilitation efforts that support the school, training, and work activities of young adults with SMHC to improve their long-term career trajectories.

Collaboration between mental health and vocational rehabilitation programs for transition-age youth vocational outcomes.

The present study's objective was to assess the extent of collaboration between VR programs and MH programs that serve this age group and to identify interorganizational factors associated with collaboration levels. Participants were 100 key informants from VR, and child mental health (CMH), transition-age youth MH (TAYMH), and adult mental health (AMH) programs in communities that received federal funding to improve services for TAY with or at risk of SMHC. Participants completed web surveys that queried four interorganizational factors and employed a modified social network analysis methodology to assess collaboration levels. The interorganizational factor, depth of knowledge, had a strong and consistent association with collaboration levels. There was little difference in MH-VR collaboration levels between MH programs serving different age groups. However, VR programs and CMH programs had both lower depth of knowledge of each other and lower collaboration levels, compared to TAY and AMH programs. Collaboration between VR and MH programs is instrumental to making sure that TAY with SMHC receive appropriate career development and employment services. Increasing the depth of knowledge that programs have about each other may enhance collaboration and appears particularly needed between VR and CMH programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Multidimensional wellness for people aging with mental health conditions: A proposed framework.

This project aimed to develop a synthesized framework of multidimensional wellness for people aging with serious mental health conditions (SMHC) using existing frameworks to serve as a guide for policy and interventions to address the unique needs, experiences, and strengths of the population. A concept analysis compared a widely used wellness approach (Swarbrick, 1997) for people with SMHC and one for older adults (Fullen, 2019) to synthesize into a practical framework for people aging with SMHC. Nine dimensions were proposed for conceptualizing the wellness of this population including: (a) Developmental, (b) Intellectual/Cognitive, (c) Physical, (d) Emotional, (e) Social, (f) Occupational, (g) Spiritual, (h) Environmental, and (i) Financial. Practical suggestions for implementation are identified. People aging with SMHC require rehabilitation services that address their unique perspectives, strengths, and challenges. The proposed adapted wellness framework offers a guide to comprehensively address well-being in people aging with SMHC. Placing the model in the context of external factors of resources and supports available, and the impact of societal perspectives about each dimension, further delineates a holistic model of wellness that considers well-being and successful living. This model can offer structure and practical application for services, and consideration of future needs of people aging with SMHC to support psychiatric rehabilitation services, as well as offer strategies to encourage positive aging and recovery. Future work should explore the impact of multidecade experiences of mental health conditions and the mental health system to better support individual recovery. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Challenging Yet Motivating Journey: The Experiences of Young Adult Parents With Serious Mental Health Conditions in the USA.

In recent decades the average age of becoming a parent has increased, the rate of teen pregnancies has decreased, and a new developmental period of emerging adulthood is marked by diverse pathways into adulthood. Today, those who become parents in young adulthood (18–24 years old) and their children may be vulnerable to poor outcomes observed in teen parents (13–19 years old) of previous generations. Young adults with serious mental health conditions (SMHC) who encounter additional challenges navigating young adulthood and tend to parent earlier than their peers may be at particularly increased risk of poor outcomes. To date, little research has been done to understand the experiences of young adult parents, especially those with SMHC. This study describes themes from qualitative interviews with 18 young adults with SMHC in the United States who became parents before the age of 25. Life story narrative interviews, conducted mostly by young adults with lived experience, asked participants to describe their parenting and mental health experiences and their school, training, and work experiences. Participants described the challenges of simultaneously parenting young children and managing a mental health condition, experiences of discrimination, and fear of future discrimination related to their mental health condition. However, parents also expressed that their children motivated them to maintain recovery and build a good life for their family. This is the first study to qualitatively explore the experiences of young adult parents with SMHC. While many of these findings align with prior qualitative research on mothers with mental illness, by exclusively focusing on individuals who become parents earlier than their peers and including father experiences, this research adds to our understanding of how individuals simultaneously navigate parenting and managing a serious mental health condition. These findings should inform larger-scale research studies on the experiences and outcomes of young adults with SMHC who become parents in their late teens or early twenties. A better understanding of their experiences should inform public mental health services that incorporate parenting as an important element of an individual's personal recovery model.

Explaining engagement in outpatient therapy among adults with serious mental health conditions by degree of therapeutic alliance, therapist empathy, and perceived coercion.

Objective: Adults with serious mental health conditions (SMHC) experience higher rates of disengagement from treatment. Factors associated with engagement in treatment in general for this population include therapeutic alliance, provider empathy, and perceived coercion. This cross-sectional exploratory study addressed the question: To what extent do client perceptions of therapeutic alliance, therapist empathy, and perceived coercion explain the degree of engagement in outpatient therapy for adults with SMHC? Method: An anonymous online survey measuring study variables was completed by 131 participants. The relationship between variables was tested using multivariate regression analysis with hierarchical blocks. Results: After separating therapeutic alliance and therapist empathy in the analysis due to multicollinearity and accounting for the influence of control variables, therapeutic alliance (B = .43, p < .01) and therapist empathy (B = .25, p < .01), but not perceived coercion, were associated with the degree of client engagement. Conclusions and Implications for Practice: For adults with SMHC enrolled in outpatient therapy, therapeutic alliance explained the greatest variation in the degree of engagement. Participants appeared to use outpatient therapy as a main strategy for pursuing recovery, and engagement in therapy may be increased if providers utilize strategies to strengthen expressions of empathy and bolster alliance. Additional research is needed to enhance understanding of engagement in therapy for this population and to develop more sensitive measures for evaluating these constructs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Overview and Innovation of Ovarian Cancer in Developed and Developing Country

Ovarian cancer is referred as impairment due to asymptomatic existence. It is task for oncologist because of its serious health conditions. Most cancer is a crew of illness which is caused by means of multiplication or increase of cells, i.e. in out of control and spread to different a part of the body. They additionally recognized as â€oeSilent killer†also refer as ‘Ovarian carcinoma’. It is a deadly disease mostly involved in women over 40 years of age or upto 55-64. It is the 6th common tumor. In 20’s and 30’s of age it is exceedingly rare to occur. Some studies recognize that, now a day’s pregnant ladies also diagnosed with ovarian cancer. Adnexal tumor is identified in most of the cases. They show that malignancy is rising in the course of pregnancy. In every year, more than 200,000 new instances are identified. Ovarian cancer often goes undetected until it has spread within the pelvis and stomach. At that last stage, it is more difficult to treat and can be fatal. Because ovarian cancer has no symptoms in the early stage’s treatment will be delayed. Its treatment will depend on stages. Surgery and chemotherapy are generally used to treat ovarian cancer. Chemotherapy was done by administration of 6 cycles of intravenous with Carboplatin and Paclitaxel along with radiation therapy and also some other drugs which used in the treatment are Metformin, Bevacizumab. Novel targeted therapies are the advanced treatment for screening and understanding of ovarian cancer. In targeted therapies mainly Nanotechnology based drugs are developed for reduction of toxicity and side effects. The article aims to analyse the recent studies and review on general information such as epidemiology, symptoms, risk factors, early detection, imaging or screening, diagnosis, staging, prevention, management and recent studies. The paper also aims to provide insight into the quality-of-life concerns of ovarian cancer patients such as how the treatment will affect the patient, how they survive, support services, society and also discuss about how the current situation COVID-19 will affect the patients.

State-of-the-Science Conference Proceedings: Improving Education, Training and Employment Outcomes for Youth and Young Adults with Serious Mental Health Conditions

The Learning and Working During the Transition to Adulthood Rehabilitation Research &amp; Training Center (Learning &amp; Working Center; LWC), UMass Chan Medical School, conducted a state-of-the-science conference, “Improving Education, Training and Employment Outcomes for Youth and Young Adults with Serious Mental Health Conditions.” The State-of-the-Science Conference was held during and at the end of the 31st Annual Research and Policy Conference on Child, Adolescent, and Young Adult Behavioral Health (a.k.a. The Tampa Conference) in Tampa, Florida sponsored by the University of South Florida between March 4-7, 2018. The LWC held a post-Tampa Conference “think tank” session with 28 participants to summarize the current knowledge base on the education, training, and work lives of youth and young adults with serious mental health conditions (SMHCs) and to identify future research needed to move the field forward. The proceedings herein include all conference papers and responses as well as final considerations for the future research directions in education, employment and policy and practice.

Strategies to Support the Education Goals of Youth and Young Adults with Serious Mental Health Conditions: A Case Study.

This manuscript describes efforts to support youth and young adults living with serious mental health conditions (SMHC) as they pursue their education goals. Case studies were conducted with three supported education initiatives across the US. Data were collected through individual interviews and focus groups. Key ingredients exist across various settings (e.g., mental health, post-secondary education) to support the pursuit of education goals for students living with SMHC, while individual settings have unique circumstances to address. Findings can inform stakeholders of relevant core components and implementation strategies across settings that support education goals for students with SMHCs.

Peer Academic Support for Success (PASS): Peer Coaching for College Students with Serious Mental Health Conditions (SMHCs) [English and Spanish versions

The Peer Support for Success (PASS) coaching intervention provides a full school year of individualized academic peer coaching to freshman and sophomore college students with Serious Mental Health Conditions (SMHCs). The goal of coaching is to support academic success and self-efficacy. A Spanish translation of this publication is available for download.

Workforce Innovation and Opportunity Act (WIOA) and its Application to Youth and Young Adults with Serious Mental Health Conditions (SMHC) [English and Spanish versions

Many sections of the Workforce Innovation and Opportunity Act are specific to students and to youth with disabilities. Though none pertain specifically to youth with significant psychiatric disabilities there are many areas that providers, advocates, family, members, and youth themselves should be aware of as avenues for possible employment related services and interventions. This brief will highlight some of the key topics to consider. A Spanish translation of this publication is available for download.

Introduction to the Special Issue: Empirically-based Interventions for Emerging Adults with Serious Mental Health Conditions.

Introduction to the Special Issue... Young people in late adolescence and early adulthood have higher rates of serious mental health conditions (SMHCs) than any other age cohort in the U.S. population, yet they are also the age group least likely to engage in services. Research evidence developed over the past decade and a half has amply documented the poor outcomes and difficult life trajectories experienced by older adolescents and young adults with SMHCs; however, only recently has attention been turned to developing interventions that respond to their unique needs and preferences. This special issue of the Journal of Behavioral Health Services & Research highlights new research that contributes to knowledge about interventions and programs that are successful in improving outcomes for emerging adults, older adolescents and young adults between the ages of about 17 and 25, who experience serious mental health conditions. The papers that comprise this special issue describe research that is grounded in what can be described as a “positive developmental” approach to working with emerging adults with SMHCs. The lead article1 for the issue describes this positive developmental approach in terms of a set of core features that are shared across a number of interventions and programs that have empirical evidence of effectiveness for the population. The article points out that, despite the apparent success and growing popularity of interventions and programs that incorporate these shared features, there has not been any clear theoretical description of why or how interventions built around the features should “work” to produce desired outcomes. The article draws on existing research and a blend of theories, including theories of positive development, self-determination, ecological systems and social capital, to propose a general theory of change for positive developmental approaches to improving outcomes for emerging adults with SMHCs. The paper argues that a clearer theoretical specification can contribute to the creation of efficient strategies for building the research base and for training providers to work more effectively with the population. The subsequent papers included in this special issue reflect the diversity of strategies that are being used to develop and evaluate interventions that include features of the positive developmental approach and that are designed specifically to improve outcomes for emerging adults with SMHCs. Several of the papers focus on efforts to adapt interventions that have evidence of success with other populations,2-4 while another paper focuses on an intervention originally developed specifically for emerging adults with SMHCs.5 An additional paper describes research on a culturally grounded intervention approach focused on supporting positive Introduction to the Special Issue: Empirically-based Interventions for Emerging Adults with Serious Mental Health Conditions

A theory of change for positive developmental approaches to improving outcomes among emerging adults with serious mental health conditions.

Recent evidence attests to the shortcomings of typical services for improving outcomes among emerging adults with serious mental health conditions (SMHCs). Researchers and providers have responded by developing new programs and interventions for meeting the unique needs of these young people. A significant number of these programs and interventions can be described as taking a positive developmental approach, which is informed by a combination of theoretical sources, including theories of positive development, self-determination, ecological systems, and social capital. To date, however, there has been no comprehensive theoretical statement describing how or why positive change should occur as a result of using a positive developmental approach when intervening with this population. The goal of this article is to propose a general model that "backfills" a theory behind what appears to be an effective and increasingly popular approach to improving outcomes among emerging adults with SMHCs.

Reducing recidivism and symptoms in emerging adults with serious mental health conditions and justice system involvement.

The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18-21year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n = 41) were aged 17-20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post-analyses revealed significant reductions in participants' MH symptoms, justice system involvement, and associations with antisocial peers.

An Engagement Intervention for Young Adults with Serious Mental Health Conditions.

Young adults with serious mental health conditions (SMHCs) often do not engage continuously with mental health services, and there are few engagement interventions designed for them. This qualitative study presents a blueprint for conceptualizing and developing an engagement intervention designed for young adults with SMHCs. The blueprint includes the following activities: (1) establishing a strong theoretical basis, (2) designing an initial manual based on previous research and practice, (3) systematically examining feedback on the manual from stakeholders, and (4) examining the feasibility, acceptability, and implementation demands of the intervention. Interviews, group discussions, and journaling were utilized to collect information from young adult participant-researchers, intervention facilitators (i.e., recovery role models and clinicians), and additional stakeholders (e.g., clinic staff and administrators) (N = 43). Analyses were performed with multiple coders using constant comparative methods. Results revealed critical information to improve the intervention, while also suggesting that the engagement intervention for young adults with SMHCs has promise.

Appealing Features of Vocational Support Services for Hispanic and non-Hispanic Transition Age Youth and Young Adults with Serious Mental Health Conditions

Transition age youth and young adults (TAYYAs) diagnosed with serious mental health conditions (SMHCs) are at greater risk of being unemployed compared to their peers without SMHCs. Job counseling and job placement services are the greatest predictor of competitive employment, yet we have limited knowledge about what TAYYAs believe they need to obtain gainful employment. In person, qualitative interviews were conducted with 57 non-Hispanic and Hispanic TAYYAs with SMHCs enrolled in three vocational support programs in MA (Vocational Rehabilitation, Individual Placement and Support; the Clubhouse Model as described by the International Center for Clubhouse Development). Six themes emerged from the data: three themes were identified as social capital (supportive relationships, readily available workplace supports, and vocational preparation), two themes related to human capital (effective educational supports and work experience), and one theme related to cultural capital (social skills training). Unique features (Spanish-speaking staff and/or familiar in Latino culture, familial-like staff support) were frequently noted by Hispanic TAYYAs.

Caring for Adult Survivors of Childhood Cancer

Adult survivors of childhood cancers are at risk for developing serious health conditions, mostly related to their original cancer treatments (NEJM JW

Preventive and therapeutic approach to the locomotive syndrome

The locomotive syndrome is a serious health condition that places the elderly at high risk of requiring support and long-term care caused by common age-related musculoskeletal disorders such as osteoporosis, osteoarthritis and sarcopenia. Accumulation of epidemiological evidence is required for the prevention strategy of the locomotive syndrome. Exercise intervention may be useful for the treatment of this condition.

Becoming an Adult: Challenges for Those with Mental Health Conditions [English and Spanish versions

This brief will describe psychosocial development and family life cycle changes during the transition to adulthood in typical youth and youth with serious mental health conditions (SMHC). We also describe additional challenges this population faces, and what can be done to support them and improve their outcomes. A Spanish translation of this publication is available for download. Originally published as: Transitions RTC Research Brief 3, 2011.