Supports that young adults with serious mental health conditions need to succeed in school, training, or work

Prior research tells us that young adults (ages 16–25) with serious mental health conditions (SMHC) struggle to persist in their education, training, and employment pursuits. Common reasons for why they struggle are often based on mistaken and harmful stereotypes that young adults in general are lazy, or that young adults with SMHC are not as smart as their peers or are incapable of working. The truth is, most young adults with SMHC want to work and pursue post-secondary school and training like their peers, are fully capable of achieving good grades, and with the proper supports and understanding, can successfully navigate school, training, and work. Education and employment efforts in young adulthood predict long-term career success and earnings. In order to better support young adults with SMHC, providers, families, educators, and employers need to understand what factors contribute to or hinder their success in school, training, and work pursuits.

Several years ago, older young adults, ages 25-30, with serious mental health conditions sat down with young adult interviewers from the Transitions to Adulthood Center for Research at the University of Massachusetts Medical School to reflect on their experiences in school, training, and work during early adulthood. Through these conversations, it became apparent how many of their school, training, and working paths were nonlinear. The research team identified three common challenges that contributed to abbreviated and disjointed school, training, and work pursuits: a) situational or stress-induced anxiety or panic, b) episodic periods of increased mental illness symptomatology (including times when they needed to navigate psychiatric medication changes or brief hospitalizations, and c) interpersonal conflicts within the context of school, training, or work. Relatedly, young adults often endorsed several common factors that could or did help young adults persist in school, training, and work: a) flexible environments, and b) supportive supervisors, teachers, or professors.

How do these experiences actually play out? We heard many common stories. For example, Brad illustrates the challenges he experienced on campus while trying to pursue his undergraduate degree: “For me, content tends to come easily and it’s more managing myself and my anxiety in being in a classroom for that prolonged period….I have a 4.0 GPA, and content is not the issue. It’s being on campus, just being around people, walking into a classroom that tends to be the biggest issue. Going to class, attendance you know. And I think that will always probably be my biggest struggle”. Brad had several unmet needs: flexible learning environments that allowed room for anxieties, coping skills to manage those anxieties, and institutional policies that allowed for short-term interruptions to learning.

On the job, many young adults acknowledge their own patterns of “ghosting”: walking out on jobs and never returning or communicating back to them. Jennifer shared “I started to get more of the panic attacks and stuff. I would just be like, I’m not doing this work no more, easier to not even talk about it and just forget about it. But I mean you just can’t walk out of your jobs like that.” The process of “ghosting” jobs is detrimental to building up a strong work history. When young adults walk out of a job, they lose that reference and often fear putting that experience on their resume. As a result, work histories may appear more stunted than they really are. If they only had the proper coping skills and/or space to process difficult stressors, including interpersonal challenges, those challenges would not have to mean the end of an endeavor.

Online learning environments and slower-paced jobs are beneficial for young adults who perhaps need to move at their own pace. Kim stated: “I think having sort of a very sort of relaxed atmosphere for a job really helped. So that I knew if I needed a break, I could go take it. If I needed to check my phone, I could. If I needed just a moment to calm down, you know I had that. Or if I needed to adjust my hours, you know there were things in place for me to be able to do things like that.” Unfortunately for Kim and many other young adults, jobs that provide flexibility and autonomy are often found in upper management positions or at least in the primary labor market, i.e., in positions that many young adults don’t qualify for. If only we allowed room for growth and flexibility in more entry-level jobs, perhaps we would see more young adults sustaining employment in the long-term.

Overall, young adults need coping skills and school, training, and work environments that fit their needs. The COVID pandemic has afforded more opportunities for remote/online learning and working, so its possible many young adults have more recently found this flexibility. But service providers, employers, and teachers need to recognize what types of support will enable youth to grow as employees and facilitate on-the-job learning without causing them to simply walk away. For every job or class a young adult with a mental health condition walks away from, there are endless lost opportunities. When building a career in young adulthood, every opportunity counts. And we owe it to help support young adults in pursuing these opportunities.

Full article: Sabella, K. (2021). Factors that hinder or facilitate the continuous pursuit of education, training, and employment among young adults with serious mental health conditions. Psychiatric Rehabilitation Journal. Advance online publication.

Kathryn Sabella, PhD, is Assistant Professor within the Transitions to Adulthood Center for Research, Department of Psychiatry, University of Massachusetts Medical School.

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