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Social Determinants, Mental Well-Being, and Disrupted Life Transitions Among Young Adults with Disabling Mental Health Conditions

Cook, Judith A
Jonikas, Jessica A
Burke-Miller, Jane K
Aranda, Frances
Mullen, Michelle G
Davis, Maryann
Sabella, Kathryn
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Journal Article
Publication Date
2025-01-13
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Abstract

This study sought to understand how young adults (age 18-25) with histories of mental health disorders are coping with disrupted transitions to adulthood during the COVID-19 pandemic. A cross-sectional web survey was conducted in March-June 2021 of 967 US young adults with pre-pandemic psychiatric disability to assess their current psychiatric status, interrupted transitions, and associations with social determinants including income, community participation, and social context. Mental health was assessed with the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and PTSD Checklist-Civilian Version. Social determinants were identified with the Epidemic-Pandemic Impacts Inventory. Interrupted transitions were measured with the Young Adult Disrupted Transitions Assessment. Multivariable logistic regression models predicted four types of transition disruptions and associations with current mental health, social determinants, and demographic factors. Disruptions were reported by 81.1% including interrupted education completion (38.3%), employment careers (37.6%), residential independence (27.7%), and intimate partner relationships (22.9%). Many screened positive for major depressive disorder (81.7%), PTSD (85.5%), or GAD (58.6%). Disruption in establishing intimate partner relationships was associated with depression, anxiety, and PTSD. Interrupted residential independence was associated with anxiety. Interrupted education completion was associated with PTSD. Interrupted employment was associated with anxiety. Social determinants significant in these models included social connections, community participation, income, and racial/ethnic identification. Results illuminate ways that current mental health and social determinants affect transition interruptions during the pandemic. Findings suggest the need for interdisciplinary approaches, integrated models of care, and assistance accessing treatment, rehabilitation, and community support services from adult service systems.

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Cook JA, Jonikas JA, Burke-Miller JK, Aranda F, Mullen MG, Davis M, Sabella K. Social Determinants, Mental Well-Being, and Disrupted Life Transitions Among Young Adults with Disabling Mental Health Conditions. J Behav Health Serv Res. 2025 Jan 13. doi: 10.1007/s11414-024-09924-0. Epub ahead of print. PMID: 39806229.

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10.1007/s11414-024-09924-0
PubMed ID
39806229
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Open Access: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Crea- tive Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.