Recovery Among Young Adults with Serious Mental Illness

Background and Purpose: Prior research shows that approximately 75% of psychiatric disorders emerge by age 24 (Kessler et al., 2005). This is noteworthy, as the burden of mental illness during the transition to adulthood can disrupt the interpersonal, educational, and professional growth opportunities that occur during this critical developmental stage. Recovery, defined by the medical model as symptom reduction and a return to normalcy (Davidson et al., 2005), is crucial for young adults. The service-user model, an alternative model, is rooted in a personalized process of finding new identities while managing symptomatology. This study builds upon both models to examine what predicts young adults’ level of personal recovery.

Methods: Data were drawn from Wave 1 of a pilot feasibility trial of a psychosocial intervention for young adults with serious mental illnesses (SMI) (N = 99). Recovery was assessed with the Recovery Assessment Scale (RAS, Corrigan et al., 2004), a 20-item scale with a range of 20-100 [e.g., “Coping with my mental illness is no longer the main focus of my life.”]. Predictors included demographics, adverse childhood experiences, psychiatric symptoms, depression, stress, hope, stigma, and informal support. Bivariate and OLS regression analyses were utilized.

Results: The average age of the sample was 26.76 (SD = 3.88). Sixty-six percent were male and identified as Black (43.75%), Latino (36.46%), or Bi/Multi-racial (19.79%).The average recovery score was 81.27 (SD = 11.50) ranging from 40-100. There were no significant differences in recovery by sex or age. When examining recovery by race, being Latino was associated with lower recovery scores than being Black (b = -6.01, p = .01) and being Bi/Multi-racial (b = -6.22, p = .04). All predictors, except adverse childhood experiences and depression, were significantly associated with recovery (p <.001). Only hope was positively associated with recovery (r (94) = .71, p<.001), while all other significant predictors were negatively associated. A final multivariate model with symptomatology, perceived stress, hope, stigma, and supports predicted 64% of the variance in recovery (adjusted R² = .64, F(10,68) = 14.99, p < .001). Holding all other predictors constant, hope remained statistically significant (b = .58, p <.001) and accounted for the highest variance in recovery (sr² = .24), followed by symptomatology (sr² = .009).

Conclusions and Implications: Findings indicate that for young adults living with serious mental illnesses, hope is a strong predictor of recovery. These findings align with the developmental trajectory of young adulthood. Developmental researchers have identified hope as a protective factor against challenges young adults face while maneuvering new relationships and life goals of adulthood (i.e., hope is a significant variable in young adult development and personal recovery). Addressing hope, through service-user recovery models, therefore, may be particularly suited for young adults with SMI who face added challenges of managing mental illness while managing the transitions that are part of becoming an adult. Additionally, the difference in recovery for Latino young adults is notable. Future studies are needed to examine how racial and ethnic identities may influence personal recovery.