One in five young adults (age 18-25) in the U.S. experience a past year mental disorder, commonly including depression or anxiety. Yet, 1.5 million young adults each year do not receive needed mental health services and are unlikely, in general, to seek formal mental health care. A pressing need exists to develop innovative approaches that successfully engage the young adult population and meet their unique needs and preferences.
In this study, we aimed to inform the development of a novel program for young adult mental health by first eliciting the experiences of young adults having prior interactions with mental health providers.
Four focus groups with 19 young adults recruited through social media were conducted as part of a larger intervention study for depression and anxiety. Participants were mostly female (78.9%), White (84.2%), with some college completed (84.2%). Mean age of receiving their first mental health diagnosis was 16 years old (min, max=12, 21), most commonly for major depressive or an anxiety disorder. Fourteen (73.7%) participants reported trying an average 2.5 (sd=2) psychiatric medications, and most (78.9%) described past use of counseling services. Participants’ prior positive and negative experiences with services/providers were elicited along six pre-defined recovery-related concepts: feeling listened to and validated, inclusivity, full information and consent, hope and optimism, connectedness, and change. Focus groups were audio recorded and transcribed verbatim, and uploaded into NVivo software. Deductive thematic analysis was used to identify patterned responses using two independent coders and a third coder to check agreement and arrive at consensus.
Feeling listened to and validated was frequently mentioned and appeared as a cornerstone of other recovery concepts. Participants discussed full information and consent primarily in the context of past negative experiences with psychiatrists. Receiving no information on treatment options appeared as a significant point of strife and regret for participants who were put on medications in their teenage years. White females in this sample also shared confusion around making sense of their distress in the absence of trauma or systemic oppression in their lives, further fueling a sense of isolation. Young adults noted how their hope and optimism were low because of a general focus by professionals to address immediate symptom-based issues, rather than on improving their overall lives. One-size-fits-all tools, such as medications or mindfulness that were sometimes “pushed” by professionals, frustrated participants. Interactions that focused on medication-taking were interpreted as the professional lacking a sincere desire to help. Young adults were particularly sensitive to inauthenticity and superficial interactions. This left young adults craving care that incorporated their whole lives and acknowledged mind-body connections.
Conclusions and Implications
Young adults described themselves as whole persons with complex lives. They expressed their desire for mental health care that acknowledged inter-connections and prioritized improving their lives over “feeling better” in a given moment. We discuss how mental health providers can develop programs that shift focus away from an exclusively medical understanding of distress and towards holistic, educational, or relational approaches that value body, mind, and authentic connection.