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Young adults (age 18-25) report high rates of depression, anxiety, and psychosocial distress, and are generally less likely to seek formal mental health care. Prior research has explored young adults’ preferences against narrowly focused treatments, such as prescribed medications, and their values for authenticity, connection, and respect. These preferences do not align well with the medical-disease model of distress, which is criticized for being overly reductionist and dismissive of complex lived experiences.
This pilot evaluation study tested the efficacy of an innovative holistic intervention for young adult depression/anxiety as it compares to medication-based treatment-as-usual in the community. The Learning & Self-development Collaborative is a 13-week program developed from a grant-funded academic-community partnership, incorporating naturopathic coaching and multi-vitamins, consciousness-raising self-learning from a non-medical framework, and peer support groups.
Methods
A mixed-method, quasi-experimental study evaluated effects on mood, social connectedness, quality of life, and empowerment at four time points, including two-month follow-up. Young adults recruited from the community with moderate/severe depression and/or anxiety were screened into the intervention (n=26) or comparison group (n=13). Intervention participants were required to be currently medication-free; comparison participants continued with regular outpatient psychiatric care including daily medication. Most participants were female (76.9%), White (82.1%), had prior diagnoses of clinical depression or anxiety (71.8%), and had previously tried an average of two psychiatric medications (74.4%). A linear mixed effects analysis assessed group differences across time and compared changes across groups between time; a random effect for individual accounted for repeated measures. Tukey’s adjustment accounted for multiple comparisons.
Findings
At baseline, intervention participants scored in the 70th-85th percentiles for depression, anxiety and global severity of distress among outpatient psychiatric populations according to the Symptom Checklist 90-Revised. At follow-up, scores reduced to the 25th-45th percentiles across domains. Comparison participants’ symptom scores remained stable across time points. Mean scores on the Social Connectedness Scale increased by 9.2 for intervention participants over the study period (baseline mean (M)=65, SE=3.26; endpoint M=74.3, SE=3.4; p=0.024) and 1.5 for comparison participants (baseline M=64.1, SE=4.61; endpoint M=65.6, SE=4.67; p=1.000), the former which approaches norms among college students with no mental health difficulties. Similar trends were observed on the Empowerment Scale, measuring self-efficacy, optimism, and powerlessness. A significant interaction between time and group existed for Quality of life (QOL; p=0.0156). QOL was low at baseline (M=34.1, SE=4.03) for intervention participants, improving to moderate-high at follow-up (M=58.5, SE=4.50; p<0.001). QOL for comparison participants did not change (baseline M=46.1, SE=5.70 and follow-up M=54.8, SE=4.50; p=0.660). Qualitative focus groups illustrate the subjectively experienced impact of the intervention.
Conclusions/Implications
Young adults in this intervention demonstrated continuous improvement across multiple measures over six months. Comparison participants taking daily psychotropic medication demonstrated no significant improvement over time. A holistic self-learning model is a viable and potentially cost-effective alternative to standard outpatient psychiatric care. Consciousness-raising curriculum developed in this project is available open-access for future replication. This and other alternatives should be rigorously evaluated for long-term impacts on mental health trajectories, and in particular, for their potential to reduce chronic reliance on psychotropic medications.