
- Vol 32 No 12
- Volume 32
- Issue 12
Introduction: A Demographic With a Challenging Set of Problems
The challenges in providing mental health care to the college community are significant. Here's a brief look at the issues.
YOUNG ADULT PSYCHIATRY
Arnett1,2 proposed a new period of the life cycle in the US-
Despite the fact that there is now a professional society and journal devoted to the study of emerging adulthood and that those in child and adolescent psychiatry/psychology and college mental health, for example, wish to demarcate an area of specialty practice, emerging adulthood as a concept remains controversial and without robust research support.3 In part, this lack of research reflects that the study of adult development takes many years, is inextricably linked with cohort effects, and is highly dependent on the era in which people live. Poverty, family constellation shifts, trends in substance use, demographic changes, ethnic and gender diversity, and economics are but a few of the factors we face during our rapidly changing lifetime.
This 2-part Special Report on Young Adult Psychiatry reflects my belief that many of the clinical challenges in the treatment of young adult patients are developmentally continuous with and heavily influenced by pre-existing vulnerabilities. The challenges in providing mental health care to the college community, for example, are significant and have been well documented given the large number of students matriculating to institutions of higher education with previous psychiatric diagnoses and treatment in conjunction with those seeking mental health services for the first time.4
[[{"type":"media","view_mode":"media_crop","fid":"44412","attributes":{"alt":"© Sergey Nivens/shutterstock.com","class":"media-image media-image-right","id":"media_crop_414655566936","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4960","media_crop_rotate":"0","media_crop_scale_h":"124","media_crop_scale_w":"175","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"float: right;","title":"© Sergey Nivens/shutterstock.com","typeof":"foaf:Image"}}]]Epidemiologically, many psychiatric disorders are disorders of young people and occur in precollege students. These include those related to substance abuse, mood and anxiety disorders, attention disorders, eating disorders, phobias, personality disorders, gender identity issues, maltreatment and abuse experiences, and schizophrenia. Although the prevalence of some of these disorders does increase between the ages of 18 and 25-and others decrease-I remind clinicians to examine childhood and adolescent development prior to high school graduation to appreciate gene-
Many of the clinical challenges in the treatment of young adult patients are developmentally continuous with and heavily influenced by pre-existing vulnerabilities.
The 2013
• 14.8% had been electronically bullied, and 19.6% had been bullied on school property
• 29.9% felt so sad or hopeless almost daily for at least 2 weeks that they discontinued some usual activities
• 17% seriously considered suicide; 13.6% made a suicide plan; and 8.0% made an attempt, of which 2.7% were treated by a health care professional for either overdose, injury, or poisoning
• 18.6% drank alcohol for the first time before the age of 13, and 20.8% had 5 or more drinks in a row on at least one occasion (the definition of binge drinking)
• 23.4% used marijuana on at least one occasion
• 47.7% tried to lose weight, and approximately 5% vomited, took laxatives, or used diet pills
• 7.3% were forced to have unwanted intercourse, and 17.8% had taken non-prescribed drugs (painkillers, stimulants, benzodiazepines) at least once in their life
It is undoubtedly true that the transition from high school to college is a critical time for many. Yet the identification of students who are emotionally unprepared for higher education is a major public health focus, since college mental health services are
As the articles in this Special Report illustrate, access to psychiatric care is critical, but so too is the identification of young persons at risk-both those in college and their non-college peers (including active armed forces members and veterans)-because the consequences of untreated problems pose significant threat for lifelong success. Mindfulness and positive-psychology–based interventions are common and often helpful to many students who access college mental health programs. However, as the evidence cited in this article also reinforces, psychiatrists must treat complex disorders and behavioral problems that require sophisticated clinical psychotherapeutic and psychopharmacologic interventions, beyond stress reduction approaches.
Disclosures:
Dr Kay is Emeritus Professor in the department of psychiatry at the Boonshoft School of Medicine of Wright State University in Dayton, OH, and Clinical Professor of Psychiatry at Tulane University School of Medicine in New Orleans. He reports no conflicts of interest concerning the subject matter of this Special Report.
References:
1. Arnett JJ. Emerging adulthood: a theory of development from the late tweens through the twenties. Am Psychol. 2000;55:469-480.
2. Arnett JJ. Emerging Adulthood: The Winding Road From the Late Teens Through the Twenties. 2nd ed. New York: Oxford University Press; 2014.
3. Beardslee WR, Vaillant G. Adult development. In: Tasman A, Kay J, Lieberman JA, et al, eds. Psychiatry. 4th ed. Chichester, UK: John R. Wiley and Sons, Ltd; 2015. In press.
4. Kay J, Schwartz VH. Mental Health Care in the College Community. London: John R. Wiley and Sons, Ltd; 2010.
5. Tanner JL, Reinherz HZ, Beardslee WR, et al. Change in prevalence of psychiatric disorders from ages 21 to 30 in a community sample. J Nerv Ment Dis. 2007;195:298-306.
6. Kann L, Kinchen S, Shanklin SL, et al. Youth risk behavior surveillance-United States, 2013. MMWR Surveill Summ. 2014;63(suppl 4):1-168.
7. First year college experience. National survey of 1,502 first-year college students examines challenging transition from high school to college [press release]. New York: The Jed Foundation; October 8, 2015.
Articles in this issue
almost 10 years ago
Cannabis Use in Young Adults: Challenges During the Transition to Adulthoodalmost 10 years ago
Working Within a Campus Health Service: A Challenge With Many Rewardsalmost 10 years ago
Challenges of Transitioning From Pediatric to Adult-Oriented Carealmost 10 years ago
Still Practicingalmost 10 years ago
Cranial Electrotherapy Stimulation for Bipolar Depression: New Dataalmost 10 years ago
Physician Health and Professional Secrecyalmost 10 years ago
Psychiatric Care of Peripartum Womenalmost 10 years ago
No News Is Not Good Newsalmost 10 years ago
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