Former system youth with mental health needs: Routes to adult mental health care, insight, emotions, and mistrust

Michelle R. Munson, Lionel D. Scott, Susan E. Smalling, Hyun Soo Kim, Jerry E. Floersch

Research output: Contribution to journalArticlepeer-review


Objective: Public health concern surrounding the mental health needs of former system youth is escalating. We know very little about mental health service utilization on the other side of the developmental transition to adulthood. The purpose of this study was to explore the mental health service use experiences among former system youth with childhood histories which included mental disorder, use of publicly-funded mental health services, and use of additional public systems of care. Methods: In-depth face-to-face interviews were conducted with 60 participants currently struggling with mental health difficulties regarding their service use experiences over the transition. Participants were recruited from one Midwestern state. Multi-phase analysis was conducted utilizing immersion/crystallization, constant comparison and concept matrices. Results: Few participants received continuous mental health care across the transition, with the majority experiencing interruptions or discontinuation of care. Important facilitators of service use emerged, such as physicians, former caseworkers and family. Health clinics and parenting programs emerged as potential entrée points for reconnecting disengaged young adults to mental health services. Insight, mistrust, and emotions emerged as novel factors associated with service utilization among young adults. Conclusions: Mental health service utilization remains a complicated phenomenon over the developmental transition to adulthood. Future research is needed that closely examines the associations between insight, emotion, mistrust and service use among young adults.

Original languageEnglish (US)
Pages (from-to)2261-2266
Number of pages6
JournalChildren and Youth Services Review
Issue number11
StatePublished - Nov 2011


  • Former system youth
  • Mental health service utilization
  • Qualitative methods

ASJC Scopus subject areas

  • Education
  • Developmental and Educational Psychology
  • Sociology and Political Science


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