Transition Age Youth in Publicly Funded Systems: Identifying High-Risk Youth for Policy Planning and Improved Service Delivery

Abstract

Youth with Serious Emotional Disturbances (SED) face many challenges as they approach the transition to adulthood and adult services. This study examines publicly funded transition-age youth in order to describe the numbers and type of youth in need of policy and service planning in one state. Using Medicaid enrollment and claims/encounter data, youth with high risk of transition difficulties were identified in the following groups: SED, state custody/foster care or risk of custody, users of intensive or frequent mental health services, or having diagnoses of major mental disorders, conduct disorders, or developmental disabilities. Almost one quarter of all enrolled 14 to 17-year olds met criteria for at least one of the high risk groups, and three-quarters of these were youth with SED. High risk youth are described, with greater detail on those with SED, and implications for policy, services, and research are discussed.

Emerging adult age status predicts poor buprenorphine treatment retention

“…For instance, emerging adults with opioid dependence have been found to have high rates of conduct disorder (Subramaniam, Ives, Stitzer, & Dennis, 2010), which has been shown to contribute to difficulties remaining in buprenorphine treatment (Ohlin et al, 2011), and may be especially high among transition-age youth growing out of juvenile legal services and social services (Heflinger & Hoffman, 2008). Given the common reliance of drug dependence treatment models on concomitant involvement in self-help programs, low levels of sustained involvement in twelve-step programs during emerging adulthood (Kelly, Brown, Abrantes, Kahler, & Myers, 2008) may eliminate a recovery synergy from which older adults often benefit.…”

How Community Organizations Promote Continuity of Care for Young People with Mental Health Problems

“…8, 10, 14, 28, 59 Developmental, service, and systemic transitions are both necessary and more likely in the wake of insurance reforms (mandated by the Affordable Care Act) that extend health coverage options for young dependents though their mid-twenties. This research suggests that organizations serving young adults promote and provide continuity of care for mental health problems both when they offer more extensive services and when they actively collaborate with other organizations within a community system of care.…”

“…8 Even so, national research finds unmet needs for mental health care in the United States, particularly among underserved groups, including people without health insurance. 9 Declines in the use of mental health care among people who are between 17–18 years old raise particular concern.…”

Diagnostic Profiles Among Urban Adolescents With Unmet Treatment Needs

“…A city-wide study of children and adolescents enrolled in at least one public care sector in San Diego (MH treatment, SUD treatment, juvenile justice, child welfare, special education) found that public sectors were mostly serving youth with ADHD and disruptive behavior disorders (Garland, Hough, McCabe, Yeh, Wood, & Aarons, 2001) and that youth with SUD only had the highest levels of unmet need for services (Garland, Aarons, Brown, Wood, & Hough, 2003). Specific to adolescents, an evaluation of teens enrolled in a state-funded Medicaid program (Heflinger & Hinshaw, 2010; Heflinger & Hoffman, 2008) also documented widespread behavioral problems in multiple areas and low utilization of available treatment services.…”