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Predicting Child-to-Adult Community Mental Health Service Continuation

The Journal of Behavioral Health Services & Research volume 47, pages 331–345 (2020)Cite this article

Abstract

Serious mental health conditions peak in prevalence and incidence during the transition to adulthood (approximately ages 16–25). Young adults are at high risk for discontinuation of care when no longer eligible for child mental health services. This study uses state administrative data to examine service continuation among those aging out of child system services in Texas (N = 3135). Most (63.5%) did not enroll in adult services following their 18th birthday. Binary logistic regression analyses found that significant predictors of child-to-adult service continuation included (1) a serious primary mental health diagnosis (i.e., schizophrenia, bipolar disorder, major depressive disorder), (2) risks to self and others, and (3) number of prior-year mental health services received. These findings suggest that historical mental health policies and practices may contribute to service disconnection at age 18 in Texas. Implications for mental health policy and system reform locally and nationally are discussed.

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Author information

Affiliations

  1. Steve Hicks School of Social Work, University of Texas at Austin, 1823 Red River Street, Austin, TX, 78701, USA

    Deborah A. Cohen PhD, MSW & Mark D. Kramer PhD

  2. Thresholds Youth & Young Adult Services Research & Innovation, Chicago, IL, 60613, USA

    Vanessa V. Klodnick PhD, LCSW

  3. Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin, TX, 78712, USA

    Stephen M. Strakowski MD & James Baker MD, MBA

Authors
  1. Deborah A. Cohen PhD, MSW
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  2. Vanessa V. Klodnick PhD, LCSW
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  3. Mark D. Kramer PhD
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  4. Stephen M. Strakowski MD
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  5. James Baker MD, MBA
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Corresponding author

Correspondence to Deborah A. Cohen PhD, MSW.

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The institutional review board of the Texas HHSC approved this study.

Conflict of Interests

Deborah A. Cohen, Vanessa V. Klodnick, Mark D. Kramer, and James Baker have no conflicts of interest. Stephen M. Strakowski serves as Chair of Data Safety and Monitoring Board for Sunovion and video blogger for Medscape (WebMD). He has grant support through the University of Texas at Austin from Janssen and Otsuka.

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Cohen, D.A., Klodnick, V.V., Kramer, M.D. et al. Predicting Child-to-Adult Community Mental Health Service Continuation. J Behav Health Serv Res 47, 331–345 (2020). https://doi.org/10.1007/s11414-020-09690-9

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  • DOI: https://doi.org/10.1007/s11414-020-09690-9