The State of Connecticut’s Young Adult Services (YAS) APA Institute of Psychiatric Services Annual Meeting Washington, DC October 6, 2016 Tim othy C. Van Deusen, MD Assistant Professor, Yale School of Medicine Departm ents of Psychiatry and Child Study Center Attending Psychiatrist, Young Adult Services, West Haven, CT S L I D E 0
YAS: The History of Young Adult Services in Connecticut In the 1990’s, Connecticut’s state funded outpatient mental health programs found that young adults aging out of child-adolescent services demonstrated poor transitions to adult services. Most of these young adults had histories of trauma and neglect, along with childhood onset diagnoses including ADHD, Learning Disabilities, PTSD, Early Onset Psychosis, Separation Anxiety and Affective Disorders. Many youth in the state welfare system who emancipated at 18 became homeless, developed substance abuse dependence, and eventually presented to the adult correctional system for treatment. To address this gap in services, the Department of Mental Health and Addiction Services (DMHAS) and the Department of Children and Families (DCF) initiated a plan that would target services aimed at this underserved, vulnerable population. S L I D E 1
Special Populations Project • 1997: Approved funding for a specialized, collaborative pilot project • Collaboration of many state agencies including OPM, DCF, DMHAS, DDS, and (for a brief time), Corrections S L I D E 2
Special Populations Project (con’t) • Target populations: – History of DCF involvement with “minimal” psychiatric issues – 50 clients (ages 18-21) over a three year period – “Sexual Offenders” and individuals diagnosed with Pervasive Development Spectrum Disorders and “high-risk” behaviors – Goal: Community safety S L I D E 3
Special Populations Project (con’t) • Community treatment at Local Mental Health Authorities across the state • Supervision model S L I D E 4
Transitional Youth Program • 2000: Second collaboration between DCF and DMHAS • Young people (ages 18-21) transitioning from DCF services who would require “some support” as they transitioned to adulthood • Anticipated short length of stay S L I D E 5
Transitional Youth Program (con’t) • Treatment goal: Foster independent living skills, social skills, natural supports, substance abuse prevention, etc. • Community treatment in three private non-profit, DMHAS grantee agencies S L I D E 6
ELIGIBILITY CRITERIA • Must be between 18-25 years old • Must have a documented major mental illness • Must be willing to voluntarily participate in services • May not have an Intellectual Disability • May be diagnosed with Autistic Spectrum Disorder but must also have an existing major mental illness S L I D E 7
Who We Serve Now • Youth who are 18 – 25 years old who have: Complex psychiatric diagnoses Developmental disorders Multiple co-morbid conditions that result in severe limitations/ behavioral disorders Sexual Behavior problems Complex Trauma and/ or Abuse History of Neglect Attention Disorders Psychotic Disorders May have legal involvement 8 S L I D E 8
Who we serve now (cont’d) • Multiple hospitalizations • An average of 7 - 10 out of home placements prior to the age of 16 • Significant attachment disorders which make it extremely difficult to engage in treatment • May have co-morbid substance abuse issues 9 S L I D E 9
Who we serve now (cont’d) • Have not had the opportunity to learn any of the necessary life skills or emotion regulation skills to cope with daily challenges • Lack of education / vocational experiences • Have not had the opportunity to experience and transition through the typical developmental tasks of young adulthood 10 S L I D E 10
DMHAS Young Adults (7/ 1/ 2013 – 6/ 30/ 2014) • 16,841 (15.5%) of DMHAS population • 7,215 (12.3%) of all Mental Health Remaining Young Adults are in Substance Abuse Services, Forensic Services or a combination. Of the 16,841: 1,117 are YAS (6.6%) 11 S L I D E 11
FOCUS • Early Intervention • Engagement • Transition • Services • Recovery 12 S L I D E 12
Service Components of YAS • Young Adult Services- Office of Commissioner • Young Adult Services-Local Mental Health Authorities • Contracted PNP Services in CT • Specialized Residential Programs • Inpatient Unit S L I D E 13
Young Adult Services - OOC • Collaboration – DMHAS and DCF • Transition planning for high risk/ high need young adults • Clinical consultation, testing and development of Positive Behavior Support Plans • Identification of best practices in trauma informed services, person centered planning, supported education, peer support/ mentoring, skills training behavioral assessment/ interventions and services for young parents 14 S L I D E 14
Young Adult Services – OOC (cont’d) • Development of a trained/ skilled workforce to treat this complex population • Development of a comprehensive system of services across Connecticut 15 S L I D E 15
Transition Planning Preparing Youth for Adulthood, Reducing Culture Shock • Providers and the client begin working together to prepare the youth for transition to adult services. Planning include: Clinical needs assessment Life skills assessment On-going and regular interagency meetings to review progress and plans. Matching youth to an adult service program that might best meet his or her needs and desires S L I D E 16
Transition Action Plan (TAP) • Prior to transition from DCF to YAS services, a TAP meeting is convened. This meeting includes both the current provider and the new provider, the client, his DCF worker, family members, attorney’s and any other stakeholder. • The TAP provides a road map to transition: ensures that all documentation is available; all clinical issues are addressed; continuity of educational planning; identified housing; date of transition visits; date of intake and move in. S L I D E 17
Young Adult Services Programs offer: Crisis Services Psychiatry Rehabilitation Services Individual Psychotherapy Consultation Services Case Management Services Assessment Services Clinical Services Linkage to Vocational/ Educational Services Nursing Services Residential/ Housing Support Group Psychotherapy Programming to support young Trauma Services parents 18 S L I D E 18
MASSACHUSETTS R H O 4 N D E E W 5 I Y S 3 * * O L R A K N D 2 1 Residential LOC YAS Program Connec onnecticut Y YAS Progr ograms In-patient Unit 19 S L I D E 19
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