Supported Education for Transition Aged Youth with Psychiatric Disabilities

Transition Aged Youth and Young Adults

Increasingly, practice and policy have recognized the unique period of life between adolescence and mature adulthood, sometimes called emerging adulthood (Arnett, 2000).   Emerging adulthood is a critical life stage when the learning that occurs, both in school and in the larger world, lays an important foundation for individuals’ future work life.  This is particularly true for young people with disabilities, those dubbed “transition aged youth (TAY)”, spanning ages 14-30.  TAY with psychiatric disabilities in particular, have serious struggles in transitioning to their adult life.  Tip sheets and resources for providing PsyR services to this unique group can be found at the website of the Transitions Research and Training Center, a federally funded organization whose mission is to develop knowledge and interventions for this population.  Visit Transitions RTC for more information.

Education Needs for Transition Aged Youth

A key valued social role for mature adults is that of worker, and being successfully employed is a central effort for many PSR services.  For TAY with disabilities, education is a critical pathway to the kind of employment that can raise one out of poverty and disability benefits dependence.  Education here refers to both successful completion of secondary or high school, as well as completion of some post-secondary education or training.  However, students with psychiatric disabilities struggle at every level of education. Over 50% of students with a mental disorder (age 14 and older) drop out of high school, the highest drop out- rate of any disability group (Ellison, Rogers, Costa 2013). The proportion of TAY with psychiatric disabilities in special education that go on to a four year college is far lower than for typical students (11% compared to 40%; Wagner & Newman, 2012), and for those that do go on, there are longer delays in entering college (Newman, 2011), higher drop-out rates and low graduation rates (Kessler, et al. 1995).   

Supported Education

There is an important history of providing PsyR services aimed at improving educational attainment of adults with psychiatric disabilities.  Beginning with landmark studies by Mowbray, Collins & Bybee  (1999) and the Center for Psychiatric Rehabilitation at Boston University (Unger, et al., 1991)  supported education has developed.   There are clearly defined components of supported education (Waghorn, et al., 2004) such as assistance with acquiring financial aid, applying and enrolling in school, and acquiring educational accommodations.  Despite this, supported education has lagged behind supported employment as being considered an evidence –based practice due to limitations of the research (Rogers et al., 2010). 

Supported Education for Transition Aged Youth with Psychiatric Disabilities

Nonetheless there is a renewed emphasis on supported education services for TAY.  The recent Workforce Innovation and Opportunity Act requires state VR agencies to set aside at least 15 percent of their federal vocational rehabilitation program funds to assist students with disabilities to make the transition from secondary school to postsecondary education programs (U.S. Department of Education 2014). There is also currently a large federally-funded multi-site randomized study for treating young people with first episode psychosis (Navigate, 2015).  This collaborative approach includes supported education along with supported employment, recognizing that education is the dominant goal for many young people with psychosis (Lynde, 2014).  There are other ongoing randomized trials of supported education and efforts to systematize and manualize the service.  Future results could hold promise for establishing supported education as an evidence-based practice (Ellison, Rogers, Costa, 2013).  As PsyR practitioners encounter TAY in their practice they will likely find that completing or continuing education is a foremost goal for the student and so should be for the practitioner. Consequently, supported education for TAY with psychiatric disabilities is on the leading edge for service innovation. 

References

Arnett, J.J. (2000) Emerging Adulthood: A Theory of development from the late teens through the twenties. American Psychologist, 55(5), 469.

 Lynde, D.  (2014)  NAVIGATE Supported Employment and Education (SEE) Manual.  Retrieved from: https://raiseetp.org/StudyManuals/SEE%20Complete%20Manual.pdf.

Ellison, ML.,  Rogers, ES., Costa, A. (2013). Supporting the education goals of young adults with psychiatric conditions. In M. Davis (Ed.) Tools for system transformation for young adults with psychiatric disabilities.  State of the Science papers.  Worcester, MA: University of Mass. Medical School, Department of Psychiatry, Transitions RTC.  

Kessler, RC., Foster, CL.,  Saunders, WB, & Stang  PE. (1995). Social consequences of psychiatric disorders, I: Educational attainment.  American Journal of Psychiatry, 152(7), 1026-1032.    

Mowbray, C., Collins, M., & Bybee, D.  (1999). Supported education for individuals with psychiatric disabilities: Long-term outcomes of an experimental study.  Social Work Research, 23(2), 89-100.

NAVIGATE: A comprehensive early treatment program for people with first episode psychosis. (2015) Retrieved from:  http://navigateconsultants.org. 

Rogers, ES., Kash-Macdonald, M., Bruker, D., & Maru, M. (2010).  Systematic Review of supported education literature, 1989-2009. Boston University, Sargent College, Center for Psychiatric Rehabilitation.

U.S. Department Of Education. (2014)  The Workforce Innovation And Opportunity Act.

Overview of Title IV: Amendments to the Rehabilitation Act Of 1973. Retrieved from: 

http://www2.ed.gov/about/offices/list/osers/rsa/publications/wioa-changes-to-rehab-act.pdf

Waghorn, G., Still, M., Chant, D., & Whiteford, H. (2004), Specialized supported education for Australians with psychotic disorders.  Australian Journal of Social Issues, 39(4), 443.

Wagner, M. & Newman,L. (2012). Longitudinal transition outcomes of youth with emotional  disturbances. Psychiatric Rehabilitation Journal, 35(3), 199-208

Unger, KV.,  Anthony, WA., Sciarappa,K.,  & Rogers, ES. (1991). A supported education program for young adults with long-term mental illness.  Hospital & Community Psychiatry,  42(8), 838-842.