The Healing Partner: Reimagining Mental Health Supports for Young Adults at Critical Points of Transition

Background: Young adults have high rates of mental health needs, yet lower rates of mental health service utilization than both adolescents and older adults. Barriers to service use include lack of recognition or resistance to identifying as having mental health challenges and access factors such as insurance and transportation. For young adults experiencing homelessness, the move from homelessness to housing presents a key transition point to deploy mental health support and connect to formal, longer term supports if needed. The purpose of this presentation is to describe the development of a new role focused on time limited mental health support within a housing program and present findings on feasibility and acceptability.

Methods: The mental health support role was part of a team-based intervention adapted from Critical Time Intervention for young adults within a rapid rehousing program. Following a two-day stakeholder training with researchers, agency partners, and young adults with lived expertise, participants provided feedback through focus groups on the proposed intervention, including the mental health role. Ongoing conversations with community partners and a young adult working group further developed the role, which was renamed to healing partner (HP) and manualized. A feasibility pilot was conducted (n=8) with qualitative interviews (young adult participants, staff, and agency partners) conducted at 6 months. The HP kept field notes and participants provided feedback at the end of each session with a brief questionnaire. Focus groups and interviews were analyzed by a team using an open coding approach. The coding team also reviewed field and case notes and created a matrix to analyze these multiple data sources.

Results: Focus groups highlighted the need for a mental health role that destigmatizes mental health and incorporates a holistic approach, while also shifting the language in discussing and offering mental health support: “It’s about how we introduce some of this therapy stuff without calling it that.” Case data revealed the diverse range of mental health needs and a range of preferences for mental health services. Some identified strongly as having mental health challenges and wanted medication or therapy while others initially preferred not to meet with the HP. Additionally, findings from questionnaires, interviews, and field notes revealed the significance of space, time, and flexibility: “The HP is meeting them where they are and taking the clinical aspect to a higher level.” The HP centered young adults’ preference for length and content of the session, along with the location. Interviews following the intervention reported high acceptability and feasibility with all team members reporting key gaps filled by the HP.

Conclusions and Implications: Findings suggest that the HP holds promise as a new approach to delivering mental health services that centers young adults' voices. Low barrier services enabled young adults to receive support without self-identifying as having mental health problems. The HP provides a model that could be tested in other settings, including transitions out of foster care, residential and/or criminal legal settings, where low barrier, time limited support may enhance successful transition outcomes.