An Integrated Approach to Young Adult Mental Health Rehab

Young adults don't seek care for mental health

Why Young Adults Don’t Seek Treatment for Mental Health

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Young adults are struggling with mental health issues more than any other age group. A new report from the COVID States Project shows that half of young people ages 18 to 24 are experiencing moderate or severe symptoms of depression, and another 23 percent have mild symptoms. And yet vast numbers of young adults don’t seek care for their mental health concerns. 

The report parallels research from a Journal of Adolescent Health study published in June 2022 and using data from mid-2021. The study looked at the prevalence of anxiety and depression in young adults since the pandemic began. The researchers found that 48 percent of young adults had mental health symptoms in 2021, as compared to 20 percent in 2019.

Among those, only about a third have received treatment. And another third reported they wanted mental healthcare but did not receive it. In terms of care for depression in particular, a JAMA study released in May 2022 found that, over the past decade, half of those with depression did not get any mental health treatment.

Know the Facts

36% of young adults reported unmet needs for mental health counseling since the start of the pandemic.

What Prevents Young Adults from Seeking Care

Compared with any other adult age group, depression is most prevalent among young people, CDC statistics show. But many young people with depression do not receive any care, according to the JAMA study. The study tracked treatment trends among young adults between 2011 and 2019, and found that nearly half did not get any mental health treatment for depression.

Why is it so hard to get mental healthcare as a young adult? The JAMA study tracks the top reasons why young adults don’t seek treatment for depression. Researchers used data from the National Survey on Drug Use and Health, collected between 2011 and 2019. Participants included more than 21,000 patients ages 18 to 25 who had been diagnosed with major depression. Of these, 11,000 reported that they had not received any treatment.

Mental Health Statistics Across Race and Ethnicity

The Journal of Adolescent Health research looked at mental health among a diverse group of young adults, using data from the national Household Pulse Survey. Among these, Hispanic and Black young adults were the most likely to report mental health symptoms. About half of Hispanic/Latinx youth (51 percent), Black youth (50 percent), and white young adults (47 percent) reported experiencing symptoms of anxiety and/or depression. Among Asian American youth, 38 percent reported mental health symptoms.

The researchers also looked at the percentage of each group that needed mental health counseling but did not receive it. About half of Hispanic young adults (44 percent) reported unmet need. Among white young adults, about a third needed mental healthcare but did not receive it. For Black and Asian American youth, that number was closer to one-quarter (22 and 27 percent, respectively).

The 6 Top Reasons Young Adults Don’t Seek Care

1. Cost

“I need therapy but can’t afford it” is the biggest reason young adults don’t access mental healthcare. More than half of young adults in the study (55 percent) cited cost as the reason they did not seek care. Young adults who think they can’t afford mental healthcare may not realize that many health insurance policies cover treatment, including therapy, outpatient programs, and residential care.

While they may not have their own health insurance, young adults can stay on their parents’ plan until age 26. Or they may be eligible for a state- or federally funded health insurance plan that provides coverage for mental healthcare. Medicaid expansion in 2014 is credited with significantly reducing the number of adults with depression who did not have health insurance. However, the study found that 24 percent of Native American participants and 10 percent of AAPI young adults had no insurance coverage.

I was not surprised that cost remains the top barrier to seeking depression treatment among young adults, as it requires fundamental systemic change to address the affordability issue of mental health treatment.

Study coauthor Wenhua Lu, PhD, City University of New York School of Medicine

2. Not knowing where to go for services

A full 38 percent of young adults included in the study didn’t know how to find the right treatment. Hispanic and Asian American Pacific Islander (AAPI) and Hispanic participants were most likely to report not knowing where to go for services. More than half of AAPI (54 percent) reported this obstacle.

Young adults are sometimes overwhelmed by the range of options, and don’t know how to tell which programs will provide safe and effective treatment. However, there are various signifiers that indicate whether a mental health treatment program provides the highest-quality care, including:

3. Believing they can deal with it on their own

About a third of young adults in the study said they didn’t seek treatment because they thought they could handle the problem without it. Despite the growing awareness around mental health, not all young adults feel comfortable admitting they need help and seeking treatment. In some family cultures, ethnic groups, or religions, mental health is still not spoken about, and anxiety or depression may be seen as a failure of willpower or self-discipline. 

“Often when people reach the point of considering mental health treatment, they are at a crisis point in their life,” says Leigh McInnis, LPC, Executive Director at our Virginia location. “Depression, anxiety, trauma and other emotional and physical experiences can contribute to self-deprecating and shame-ridden thoughts: I should be stronger, other people wouldn’t need help for this, what is wrong with me that I can’t deal with this on my own? These thoughts serve as barriers to seeking and accepting support.”

4. Fear of ‘being committed’ or ‘having to take medicine’

Nearly a quarter (23 percent) of young adults in the study cited these reasons. Clearly, confusion and misperceptions about treatment continue to deter young people from getting the help they need. The media is partially to blame, as it continues to present sensationalized and unrealistic view of mental health struggles and treatment.

“I often hear parents and staff refer to the film One Flew Over the Cuckoo’s Nest as the source where they learned about residential treatment,” Leigh says. “Without having the lived experience of participating in residential care, people don’t know what to expect and what it’s really like, and fear can take over in the absence of understanding and information.”

5. Worried about repercussions at work

Young adults who do have an insurance coverage through work may be worried that employers and colleagues will find out. Or they may be afraid that they’ll have to explain why they need to take time off work for therapy or treatment.

In general, the study found, male participants were more concerned than females about getting negative reactions from neighbors or their communities if they sought treatment. It’s important to know that your employer cannot obtain information about you from your healthcare provider directly without your authorization. And it is illegal for an employer to discriminate against people who have a mental health condition. 

6. Concerns about confidentiality 

Many young adults want care but are nervous that people will find out about their diagnosis and treatment. In the study, Hispanic participants (19 percent) and Native Americans (18 percent) were more likely to report fear of others finding out they sought care.

Young adults may be afraid that a therapist or treatment center will share their information with parents or employers. As stated above, this is not the case. Unless there are other legal proceedings that require disclosure, information cannot be released without your authorization. 

Mental Health Treatment Options for Young Adults

Once a young adult is ready to access care, a mental health assessment with a doctor or clinician is typically the first step. Subsequently, young adults will be given an initial diagnosis and a recommendation for one of the various types of mental health treatment. Young people with acute diagnoses—when symptoms are very serious—may need a higher level of care, such as an inpatient hospital stay or residential treatment. For those with symptoms that are not as severe, a lower level of care may be sufficient. 

Treatment options for young adults include:

  • Weekly therapy, online or in person
  • Medication prescribed by a psychiatrist, which should always be accompanied by ongoing therapy 
  • Outpatient programming at an outpatient treatment center or community mental health program (up to five days a week, either full days or after college courses or work)
  • Inpatient care in a psychiatric hospital or the psychiatric unit of a hospital, usually for no more than 30 days
  • Residential care in a home-like setting, typically for at least 30 days, including academic and life skills programming to help young adults stay on track with their education and career goals.

How to Take Action Now to Access Mental Healthcare  

Here are some ways young adults can get help and support as quickly as possible.

  • Find an outpatient mental health center in your area. Outpatient clinics often provide free assessments and will refer individuals to other facilities or options if outpatient care is not appropriate.
  • Take Mental Health America’s free online screening. After the screening, you will receive information, resources and tools to help you understand and improve your mental health.
  • Contact your insurance company to find out about coverage for mental healthcare and what treatment facilities they work with. Many young people are not aware that their policy or their parents’ policy includes coverage for mental health treatment. If you are on Medicaid or another subsidized plan, research the mental healthcare coverage your plan provides.
  • Ask your primary care provider for a referral or a list of mental health providers in your area. Keep going down the list until you find a therapist who will take new clients and preferably accepts your insurance. If they’re not taking new clients, ask them if they’ll help you find someone who does, or if they are willing to do an assessment to help you determine the right level of care.
  • If you are in crisis, call 911 or go to the emergency room of your local hospital. 
  • Call us. Newport Institute’s Admissions counselors will help you determine what level of care may be appropriate for your or your loved one. They will also support you with the insurance verification process. If Newport Institute is not the right fit, ask to be transferred to our Clinical Outreach representative in your area to find out about the other options available. We are dedicated to helping young adults access the treatment that can help them move forward into a thriving life.
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J Adolesc Health. 2022 Jun; 70(6): 985–988.

JAMA Netw Open. 2022;5(5): e2211393. 

Front Sociol. 2019 May; 4:40: doi: 10.3389. 

Psychiatric Services. 2018 Aug; doi: 10.1176.

Treatment / May 20, 2022

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