Associate Professor Michelle Munson Awarded NIH Grant to Improve Child to Adult Transitions in Mental Health Care

The stress of transitioning to adulthood begins in adolescence and continues into the mid-20s, and for youth with mental health challenges, the transition can be extremely challenging. Data from a recent report indicate that 1 in 10 older adolescents aged 16 to 17 experienced a major depressive episode in the past year and one in five young adults aged 18 to 25 had a mental illness (CBHSQ, 2014).

Intervening with vulnerable youth in transition is the focus of a recent grant awarded to Associate Professor Michelle Munson by The National Institutes of Health (NIH). The grant provides $660,000 over three years to further develop a promising intervention that helps low-income youth with mental disorders accomplish the difficult transition from childhood to adulthood.

The intervention, called Cornerstone, provides a service delivery strategy that spans the shift from child to adult systems of care. It includes providing learning strategies to help young adults manage emotions and stress, gain or sustain jobs or post-secondary education, obtain a secure and safe place to live, and develop a support network.

Youth with mental disorders often face fragmented or discontinued care as they move from the child mental health care system to the adult system. Cornerstone seeks to bridge this gap in multiple ways. First, the intervention provides a transition facilitator who works directly with the young person as he or she moves from the child to the adult system to assure that developmentally and clinically appropriate adult services—and appropriate independence—happen starting at age 18. Second, youth receive the guidance of a recovery role model mentor, who sets up weekly group sessions and provides behavior modeling, information, and support. Third, Cornerstone is aligned with policy and practice changes under the U.S. Affordable Care Act and New York State Medicaid redesign, which have made a priority of providing coordinated, evidence-informed care and achieving functional outcomes.

Professor Munson and her team will work to refine Cornerstone’s manuals and protocols and determine the feasibility, acceptability, and preliminary impact of the intervention compared to standard treatment. This will be accomplished through a small, randomized clinical trial of Cornerstone in FEGS Health and Human Services’ outpatient clinics in New York. The team will use individual and group interviews and an advisory board to study the intervention, fidelity, and implementation questions throughout the grant period. Few evidence-based interventions exist that have been tested with this specific youth population.

Included in this team are colleagues at New York University, University of Pennsylvania, University of Chicago, and Boston University. Munson has also engaged NYU Silver’s McSilver Institute for Poverty Policy and Research and Center for Latino Adolescent and Family Health; New York State Office of Mental Health; National Council for Behavioral Health in Washington, DC; and Southwest Counseling Solutions in Detroit. The latter two collaborators have been working with Professor Munson on the project development for the past two years.

“We have the perfect team to fight the notoriously large barriers that exist when developing interventions across the developmental transition, and we have a supportive mental health agency and state system working with us along the way,” says Professor Munson.