Program and Service Needs of Dual Diagnosed Transition Age Adults

Purpose: The transition from adolescence to adulthood is a critical developmental period marked by shifting social roles and striving for independence and self-support. These issues are compounded for transition age adults with co-existing mental health and substance use disorders (dual diagnosed) whose cognitive, emotional and social development have often been compromised as a consequence of these disorders. Scant empirical attention has been given to this population. This poster compares the demographic, life functioning, work history, and illness characteristics of dual diagnosed transition age adults (18-28 years) with their older dual diagnosed counterparts (29+ years) in an effort to discern differences that may impact program development and treatment planning.

Methods: Consumers currently participating in treatment with four community mental health agencies with Integrated Dual Diagnosis Treatment (IDDT) programs served as the study's sample. Consumer questionnaires, case manager assessments and administrative records collected at baseline as part of a state department of mental health funded longitudinal study provided data for this study. Participants included 219 dual disordered consumers including 38 (17.4%) transition age adults (18-28) and 181 (82.6%) adults 29 and older. This study utilized demographic, consumer functioning/life status, illness, and work success measures to examine differences between the two age cohorts. Analyses of group difference were performed including bivariate t-tests and chi-squares and using multivariate analysis of variance (MANOVA), reporting Pillai's trace that is robust when dealing with unequal group sizes.

Results: Two-thirds of the overall sample was male and 32% African American, 62% White, 2.3% Latino, .5% American Indian/Pacific Islander, 1.8% mixed race and 1.4% other. One third had less than a high school education. The mean age of the transition group was 24.6 years and the non-transition group 42.8 years (range 29-68 years). Exploratory bivariate analyses identified the significant variables for multivariate analyses. Reliable main effects were found between the two groups at the multivariate level, F (9, 167) = 7.074, p<.001, Pillai's trace = .289. The following variables were significant (p<.05). Demographically, transitioning adults were less likely to receive entitlement income, less likely to be married and less likely to have completed high school. Regarding functioning, the transitioning adults were less successful in their activities of daily living and had lower rates of victimization. Work history indicators suggest transitioning adults were more likely to enter competitive employment and less likely to report themselves as disabled. The two groups did not differ significantly on mental health and substance use characteristics.

Conclusions/Implications: Our data suggest the importance of focusing on education and GED/diploma attainment when serving dual disordered transition age adults. Attention should also be given to supporting/monitoring these clients' activities of daily living including managing money, public transportation and housekeeping. Findings suggest that building strengths for independent living and fostering integration into the workforce may help promote a more successful transition to adulthood in this understudied population. Future research should continue to explore the needs of this population and further explicate differences from their non-transition age counterparts.