Key Helper Communication: Messages about Mental Health Services to Young Adults

Purpose: Young adults have high rates of mental disorders and some of the lowest rates of service use. Improving young adults’ willingness to use services when needed will impact their long term life trajectories. Supportive others play an important role in influencing mental health service utilization. This study examined the source and contentof health messages young adults perceive they are given by key helpers who help them with their mental health during the transition to adulthood.

Method: This cross-sectional study utilized face-to-face semi-structured interviews. All interviews were conducted between 2008 and 2010 and were professionally transcribed. Data was managed utilizing Atlas.ti software. The study is part of a larger study of young adults with mental health challenges (N=59) (mean age=20.97, 68% female, 68% Black, African-American, bi- or multi-racial). The sample for this study consisted of the 45 young adults who nominated at least one supportive adult who helped them with their mental health challenges. Example questions about relationships were: 1) what about ____do you find most helpful?; and, 2) what piece of advice has _____given you about mental health services? Participants could nominate up to three supportive adults. Three analysts used open coding (with some sensitizing concepts) and constant comparison within and between interviews on a subset of interviews (N=6). Additional transcripts were analyzed developing a codebook, adding and modifying codes as needed. Analysts utilized consensus to deal with discrepancies. The remaining cases were analyzed and discussed by two analysts. Analysts also coded the ‘source’ of each message.

Results: Ninety-seven relationships were analyzed. Results indicate family members, friends, significant others, and professionals were the most important sourcesof messages on help-seeking. Many participants state that their key helpers are providing messages suggesting that mental health services are needed, for example, “you need to go to therapy”. The great majority of individuals giving messages that young adults need therapy are informal supports. In contrast, there are a significant amount of formal helpers providing messages that young adults need to take their medications. Participants also report that key helpers are giving messages that service use is related to improved functioning. A few key helpers express suspicions about mental health providers, stating some services are good and some are bad and some mental health professionals just want to take your money. A number of supportive others, both informal and formal, are communicating messages and acting in ways that enhance young adults’ sense of efficacy. Some key helpers provide messages that young adults can choose their own mental health professional and ask others for help finding services. Key helpers also take participants to appointments and pick up their medications.

Conclusion: Understanding the content and the source of messages from supportive adults to young adults with mental health challenges can inform interventions to raise the low rates of service engagement among young adults. Further, results can inform social work professionals as to the areas where they need to provide education and, in some cases, different messages than young adults are receiving from supportive others.