Just Do You Program for Young Adults With Serious Mental IIlness

Background

Young adults have elevated rates of serious mental illnesses and they often do not receive
consistent mental health care. This is a considerable challenge for public health, as most
often mental health conditions persist into adulthood. Continuing to engage this population
in their professional mental health treatment has been a pervasive challenge globally. Few
mental health interventions have been designed specifically for young adults and none are
conceptualized as meta-interventions or orientation programs. Just Do You is a
young-adult-centered and theoretically guided intervention that has shown promise for keeping
young adults connected to their professional treatments, while also enhancing their hope for
the future and their own recovery. Just Do You is a brief two-module engagement program that
utilizes a hybrid provider team of a licensed clinician and peer to address mistrust, lack of
hope for the future, stigma concerns, literacy and a sense of efficacy early on when young
adults begin a new service experience in adult outpatient day programs (i.e., New York State
Personalized Recovery Oriented Services).

Methods/design

This study utilizes a randomized controlled trial to test the preliminary impact of the
intervention, compared to best available services (treatment as usual, TAU) at two outpatient
programs for adults with serious mental illnesses (n = 195). The program was adapted to
two-sessions from the piloted four-session version through conversations with leadership at
partnering agencies. The intervention involves intensive staff training and 24 months of
ongoing provision, monitoring and supervision of the program. Quantitative survey data will
be collected at baseline (pre), 2 weeks (post), 1 month, and 3 months. In this
intention-to-treat analysis, the investigators will conduct basic omnibus analyses to examine
whether Just Do You leads to improved outcomes relative to TAU utilizing t tests across
treatment conditions for each outcome measure specified. The investigators will likewise
examine whether changes in the proposed mediating variables differ across groups.

Discussion

The aim of this study is to test Just Do You through a moderately-sized randomized trial in
order to see if it improves initial and secondary engagement among young adults with serious
mental health conditions. The program is designed as an orientation to services, coupled with
a curriculum designed to enhance motivation and agency, and keep young adults connected to
their care. Continuity of care among this population is a serious challenge and Just Do You
has the potential to address this challenge in the service system for poor, young adults
living in low-resourced communities. If it is shown to be successful in this setting, it
could likely be used to address the continuity of care issue more broadly in additional
settings that serve young adults with serious mental illness. It may enhance the menu of care
options for those who have been recently diagnosed with a serious mental health condition,
providing them with an orientation for how professional mental health care can help them. The
program is recovery-oriented, builds on the best evidence to date, and is in line with both
local and national health care reform efforts.

Inclusion Criteria:

- between the ages of 18 and 28

- living with a serious mental illness (i.e., mood, anxiety, schizophrenia-spectrum)

- attending personalized recovery-oriented services (PROS)

- formerly involved with public systems of care

Exclusion Criteria:

- cognitive impairments (i.e., young adult cannot understand consent process or IQ<70)

- non-English speaking (we will include individuals whose primary language is not
English, but are able to comprehend and speak English).