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The Practice Gap in Health Care Transition: Focus on Young People Heading to College with a Mental Health Condition

  • Adele Martel
Chapter

Abstract

Planned health care transition for young people with special health care needs, including those with emotional, behavioral, and developmental disorders, has been deemed a health priority both here in the U.S. and abroad. However, gaps in health care transition services for adolescents and young adults continue to exist. Youth headed to college with pre-existing mental health conditions are among those in need of transition preparation and planning services. When compared to their peers without mental illness, these students face additional challenges when transitioning to college. They must have some understanding of how their illness might impact functioning in the college environment and what supports they need to aid academic and social success. They are expected to manage their illness more independently, advocate for themselves, develop relationships with new treatment providers, and navigate a new system of care. In this chapter, the definition and goals of health care transition are described. Then, by looking at the prevalence of mental health disorders in the college-age population in conjunction with recent college enrollment statistics, findings from developmental psychopathology, and survey data of incoming freshman, the scope of the need for mental health care transition services for college-bound youth is highlighted. Knowledge of normal child, adolescent, young adult, and family development, the principles of the systems of care model, tenets of educational transition planning, and anticipatory guidance, along with clinical experience and expert consensus, inform best practices in mental health care transition planning.

Keywords

Goals of health care transition Heading to college with mental illness College student mental health issues Developmental tasks of college students Mental health needs on campus Transition to college 

References

  1. 1.
    McPherson M, Arango P, Fox H, Lauver C, McManus M, Newachek P, Perrin JM, Shonkoff JP, Strickland B. A new definition of children with special health needs. Pediatrics. 1998;102(1):137–40.CrossRefPubMedGoogle Scholar
  2. 2.
  3. 3.
    Canadian Pediatric Society. Transition to adult care for youth with special health care needs (Reaffirmed 2011). Pediatr Child Health. 2007;12(9):785–8.CrossRefGoogle Scholar
  4. 4.
    McNamara N, McNicholas F, Ford T, Paul M, Gavin B, Coyne I, Cullen W, O’Connor K, Ramperti N, Dooley B, Barry S, Singh SP. Transition from a child and adolescent to adult mental health services in the Republic of Ireland: an investigation of process and operational practice. Early Interv Psychiatry. 2014;8:291–7.CrossRefPubMedGoogle Scholar
  5. 5.
    Blum RW, Garel D, Hodgman CH, Jorissen TW, Okinow NA, Orr DP, Slap GB. Transition from child-centered to adult health-care systems for adolescents with chronic conditions. J Adolesc Health. 1993;14(7):570–6.CrossRefPubMedGoogle Scholar
  6. 6.
    Paul M, Ford T, Kramer T, Islam S, Harley K, Singh SP. Transfers and transitions between child and adult mental health services. Br J Psychiatry. 2013;202:s36–40.CrossRefGoogle Scholar
  7. 7.
    American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians. A consensus statement on health care transitions for young adults with special health care needs. Pediatrics. 2002;110(6):1304–6.Google Scholar
  8. 8.
    McManus MA, Pollack LR, Cooley WC, McAllister JW, Lotstein D, Strickland B, Mann MY. Current status of transition preparation among youth with special needs in the United States. Pediatrics. 2013;131(6):1090–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Martel A, Derenne J, Chan V. Teaching a systematic approach for transitioning patients to college: an interactive continuing medical education program. Acad Psychiatry. 2015;39(5):549–54.CrossRefPubMedGoogle Scholar
  10. 10.
    Ascherman LI, Shaftel J. Facilitating transition from high school and special education to adult life: focus on youth with learning disorders, attention-deficit/hyperactivity disorder, and speech/language impairments. Child Adolesc Psychiatr Clin N Am. 2017;26(2):311–27.CrossRefPubMedGoogle Scholar
  11. 11.
    Lee T, Morgan W. Transitioning to adulthood from foster care. Child Adolesc Psychiatr Clin N Am. 2017;26(2):283–96.CrossRefPubMedGoogle Scholar
  12. 12.
    National Alliance on Mental Illness College students speak: a survey report on mental health. 2012. https://www.nami.org/getattachment/About-NAMI/Publications-Reports/Survey-Reports/College-Students-Speak_A-Survey-Report-on-Mental-Health-NAMI-2012.pdf.
  13. 13.
    Schaefer MR, Rawlinson AR, Wagoner ST, Shapiro SK, Kavookjian J, Gray WN. Adherence to attention-deficit/hyperactivity disorder medication during the transition to college. J Adolesc Health. 2017;60(6):706–13.CrossRefPubMedGoogle Scholar
  14. 14.
    National Center for Educational Statistics—Undergraduate Enrollment. https://nces.ed.gov/programs/coe/indicator_cha.asp (undergraduate enrollment data).
  15. 15.
    Sood B, Martel A. Examining common failures in campus mental health systems. In: Sood B, Cohen R, editors. The virginia tech massacre—strategies and challenges for improving mental health policy on campus and beyond. Oxford: Oxford Press; 2015. p. 65–92.Google Scholar
  16. 16.
  17. 17.
  18. 18.
    Eagan MK, Stolzenberg EB, Zimmerman HB, Aragon MC, Sayson HW, Rios-Aguilar C. The American freshman: national norms fall 2016. Los Angeles: Higher Education Research Institute, UCLA; 2017. https://www.heri.ucla.edu/monographs/TheAmericanFreshman2016.pdf. Accessed 1 June 2017.
  19. 19.
  20. 20.
    Kessler RC, Bergland P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distribution of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry. 2005;62:593–603.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Blanco C, Okuda M, Wright C, Hasin D, Grant B, Liu S-M, Olfson M. Mental health of college students and their non-college-attending peers. Arch Gen Psychiatry. 2008;65:1429–37.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Merikangas KR, He J-P, Burstein M, Swanson SA, Avenevoli S, Cui L, Benjet C, Georgiades K, Swendsen J. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49(10):980–9.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Iarovici D. Perspectives on college student suicide. Psychiatric Times. 2015;32(7):27.Google Scholar
  24. 24.
    American College Health Association-National College Health Assessment II: Reference Group Executive Summary Fall 2016. Hanover: American College Health Association; 2017. http://www.acha-ncha.org/docs/NCHA-II_FALL_2016_REFERENCE_GROUP_EXECUTIVE_SUMMARY.pdf.
  25. 25.
    Riba M, Kirsch D, Martel A, Goldsmith M. Preparing and training the college mental health workforce. Acad Psychiatry. 2015;39(5):498–502.CrossRefPubMedGoogle Scholar
  26. 26.
    Pedrelli P, Nyer M, Yeung A, Aulauf C, Wilens T. College students: mental health problems and treatment considerations. Acad Psychiatry. 2015;39(5):503–11.CrossRefPubMedGoogle Scholar
  27. 27.
    Brunner JL, Wallace DL, Reymann LS, Sellers J, McCabe AG. College counseling today: contemporary students and how counseling centers meet their needs. J Coll Stud Psychother. 2014;28(4):257–324.CrossRefGoogle Scholar
  28. 28.
    Leebens PK, Williamson ED. Developmental psychopathology: risk and resilience in the transition to young adulthood: risk and resilience in the transition to young adulthood. Child Adolesc Psychiatr Clin N Am. 2015;26(2):143–56.CrossRefGoogle Scholar
  29. 29.
    Copeland WE, Adair CE, Smetanin P, Stiff D, Briante C, Colman I, Fergusson D, Horwood J, Poulton R, Costello EJ, Angold A. Diagnostic transitions from childhood to adolescence to early adulthood. J Child Psychol Psychiatry. 2013;54(7):791–9.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    IOM (Institute of Medicine) and NRC (National Research Council). Investing in the health and well-being of young adults. Washington, DC: The National Academies Press; 2015.Google Scholar
  31. 31.
    Skehan B, Davis M. Aligning mental health treatments with the developmental stage and needs of late adolescents and young adults. Child Adolesc Psychiatr Clin N Am. 2017;26(2):177–90.CrossRefPubMedGoogle Scholar
  32. 32.
    Gore FM, Bloem PJ, Patton GC, Ferguson J, Joseph V, Coffey C, Sawyer SM, Mathers CD. Global burden of disease in young people aged 10–24 years: a systematic analysis. Lancet. 2011;377(9783):2093–102.CrossRefPubMedGoogle Scholar
  33. 33.
    Prior M, McManus M, White P, Davidson L. Measuring the “triple aim” in transition care: a systematic review. Pediatrics. 2014;134(6):e1648–61.CrossRefPubMedGoogle Scholar
  34. 34.
    Singh SP, Tuomainen H. Transition from child to adult mental health services: needs, barriers, experiences and new models of care. World Psychiatry. 2015;14(3):358–61.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    McManus M, White P. Transition to adult health care services for young adults with chronic medical illness and psychiatric comorbidity. Child Adolesc Psychiatr Clin N Am. 2017;26(2):367–80.CrossRefPubMedGoogle Scholar
  36. 36.
    American Academy of Pediatrics, American Academy of Family Physicians, American College of Physicians—Transitions Clinical Report Authoring Group. Supporting the health care transition from adolescence to adulthood in the medical home (Reaffirmed 2015). Pediatrics. 2011;128(1):182–200.CrossRefGoogle Scholar
  37. 37.
    Stroul B, Blau G, Friedman R. Updating the system of care concept and philosophy. Washington, DC: Georgetown University Center for Child and Human Development, National Technical Assistance Center for Children’s Mental Health; 2010. https://www.psy0-18.be/images/SOC_Brief2010.pdf.
  38. 38.
    Martel A, Sood B. Best practices and resources: national models for college student mental health. In: Sood B, Cohen R, editors. The virginia tech massacre—strategies and challenges for improving mental health policy on campus and beyond. Oxford: Oxford Press; 2015. p. 93–125.Google Scholar
  39. 39.
    Chan V, Rasminsky S, Viesselman J. A primer for working in campus mental health: a system of care. Acad Psychiatry. 2015;39(5):533–40.CrossRefPubMedGoogle Scholar
  40. 40.
    Winters N, Pumariega A. AACAP Practice Parameter on child and adolescent mental health care in community systems of care. J Am Acad Child Adolesc Psychiatry. 2007;46(2):284–99.CrossRefPubMedGoogle Scholar
  41. 41.
    Young CC, Calloway J. Transition planning for the college bound adolescent with a mental health disorder. J Pediatr Nurs. 2015;30:e173–82.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral SciencesAnn and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of MedicineChicagoUSA

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