Static, dynamic, integrated, and contextualized: A framework for understanding mental health service utilization among young adults

Michelle R. Munson, James Jaccard, Susan E. Smalling, Hyunsoo Kim, James J. Werner, Lionel D. Scott

Research output: Contribution to journalArticlepeer-review


Research has illuminated the problem of untreated mental illness among young adults, including evidence that young people who exit public care systems often discontinue mental health services in adulthood. The present study explored mental health service use experiences during the transition to adulthood among sixty young adults, ages 18-25, from a Midwestern U.S. state. In-depth semi-structured interviews were conducted. All participants had mood difficulties, and shared three childhood experiences: (a) mood disorder diagnosis; (b) use of public mental health services; and (c) experience with social service systems. Immersion and grounded theory coding techniques were applied to the interview data. Two major themes about mental health service use emerged from the findings, namely the changing nature of service use over time and characterizations of experiences associated with service use at a given point in time. Categories of explanatory constructs that emerged in the latter theme included perceived need, emotions, perceived efficacy of services, and social considerations, among others. Findings suggested a four-facet mid-level theory of service utilization, highlighting both the cross-sectional and time-variant character of service use and decision-making within context. Links between broader theoretical frameworks of service utilization and social psychological models of decision making were noted, and guidelines were presented for ten classes of variables that researchers interested in understanding service use by young adults should consider.

Original languageEnglish (US)
Pages (from-to)1441-1449
Number of pages9
JournalSocial Science and Medicine
Issue number8
StatePublished - Oct 2012


  • Decision-making
  • Mental health services
  • Mood disorders
  • Theoretical framework
  • Transition to adulthood
  • USA
  • Young adults

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science


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