Prevalence and Treatment of Mental Health and Substance Use Problems in the Early Emerging Adult Years in the United States

Abstract

Onset of most mental disorders occurs by the mid-20s, yet studies of mental health (MH) status are limited for younger adults (YAs) aged 18–25. The objectives were to determine YAs’ rates of MH and substance use (SU) disorders, treatment, and sociodemographic disparities. To determine relative vulnerability and unmet need, overall rates were compared between ages 18–25 and 26–34. Using the 2010 National Survey on Drug Use and Health (n = 25,216), we estimated past-year serious psychological distress, major depressive episode, alcohol and drug abuse/dependence, and treatment for both age groups and examined YA subgroup differences (gender, race/ethnicity, income, education, and insurance). YAs had higher prevalence of MH and SU disorders, but lower treatment rates than older adults. YA females had higher MH but lower SU disorder rates than males. Other sociodemographic disparities were noted. Efforts to improve YAs’ MH status are necessary to foster a successful transition to adulthood.

Keywords

mental health substance use/abuse depression gender minorities transitions to adulthood

Get full access to this article

View all access options for this article.

References

Alegria

Shrout

P. E.

Woo

Guarnaccia

Sribney

Vila

… Canino

. (2007). Understanding differences in past year psychiatric disorders for Latinos living in the US. Social Science & Medicine, 65, 214–230.

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

Arfken

C. L.

Said

Owens

(2012). Racial and ethnic differences in reported criminal justice referral at treatment admission. Journal of Psychoactive Drugs, 44, 428–433.

Arnett

J. J.

(2000). Emerging adulthood. A theory of development from the late teens through the twenties. American Psychologist, 55, 469–480.

Blanco

Okuda

Wright

Hasin

D. S.

Grant

B. F.

Liu

S. M.

Olfson

(2008). Mental health of college students and their non-college-attending peers: Results from the National Epidemiologic Study on Alcohol and Related Conditions. Archives of General Psychiatry, 65, 1429–1437.

Breslau

Javaras

K. N.

Blacker

Murphy

J. M.

Normand

S. L.

(2008). Differential item functioning between ethnic groups in the epidemiological assessment of depression. Journal of Nervous and Mental Disease, 196, 297–306.

Celano

C. M.

Huffman

J. C.

(2011). Depression and cardiac disease: A review. Cardiology in Review, 19, 130–142.

Compton

W. M.

Thomas

Y. F.

Stinson

F. S.

Grant

B. F.

(2007). Prevalence, correlates, disability, and comorbidity of DSM-IV drug abuse and dependence in the United States: Results from the national epidemiologic survey on alcohol and related conditions. Archives of General Psychiatry, 64, 566–576.

Conner

K. O.

Koeske

Brown

(2009). Racial differences in attitudes toward professional mental health treatment: the mediating effect of stigma. Journal of Gerontological Social Work, 52, 695–712.

10.

Coulehan

J. L.

Schulberg

H. C.

Block

M. R.

Madonia

M. J.

Rodriguez

(1997). Treating depressed primary care patients improves their physical, mental, and social functioning. Archives of Internal Medicine, 157, 1113–1120.

11.

Cummings

J. R.

Druss

B. G.

(2011). Racial/ethnic differences in mental health service use among adolescents with major depression. Journal of the American Academy of Child & Adolescent Psychiatry, 50, 160–170.

12.

Dismuke

C. E.

Egede

L. E.

(2011). Association of serious psychological distress with health services expenditures and utilization in a national sample of US adults. General Hospital Psychiatry, 33, 311–317.

13.

Eaton

W. W.

Martins

S. S.

Nestadt

Bienvenu

O. J.

Clarke

Alexandre

(2008). The burden of mental disorders. Epidemiologic Reviews, 30, 1–14.

14.

Edlund

M. J.

Booth

B. M.

Han

(2012). Who seeks care where? Utilization of mental health and substance use disorder treatment in two national samples of individuals with alcohol use disorders. Journal of Studies on Alcohol and Drugs, 73, 635–646.

15.

English

. (2010). The patient protection and affordable care act of 2010: How does it help adolescents and young adults. Retrieved from http://nahic.ucsf.edu/download/the-patient-protection-and-affordable-care-act-how-does-it-help-adolescents-and-young-adults

16.

Fortuna

R. J.

Robbins

B. W.

Halterman

J. S.

(2009). Ambulatory care among young adults in the United States. Annals of Internal Medicine, 151, 379–385.

17.

Galdas

P. M.

Cheater

Marshall

(2005). Men and health help-seeking behaviour: Literature review. Journal of Advanced Nursing, 49, 616–623.

18.

Gavin

A. R.

Walton

Chae

D. H.

Alegria

Jackson

J. S.

Takeuchi

(2010). The associations between socio-economic status and major depressive disorder among Blacks, Latinos, Asians and non-Hispanic Whites: Findings from the Collaborative Psychiatric Epidemiology Studies. Psychological Medicine, 40, 51–61.

19.

Gonzalez

J. M.

Alegria

Prihoda

T. J.

Copeland

L. A.

Zeber

J. E.

(2011). How the relationship of attitudes toward mental health treatment and service use differs by age, gender, ethnicity/race and education. Social Psychiatry and Psychiatric Epidemiology, 46, 45–57.

20.

Green

J. G.

Gruber

M. J.

Sampson

N. A.

Zaslavsky

A. M.

Kessler

R. C.

(2010). Improving the K6 short scale to predict serious emotional disturbance in adolescents in the USA. International Journal of Methods in Psychiatric Research, 19, 23–35.

21.

Irwin

C. E.

Jr (2010). Young adults are worse off than adolescents. Journal of Adolescent Health, 46, 405–406.

22.

Jackson

J. S.

Knight

K. M.

Rafferty

J. A.

(2010). Race and unhealthy behaviors: Chronic stress, the HPA axis, and physical and mental health disparities over the life course. American Journal of Public Health, 100, 933–939.

23.

Kessler

R. C.

Barker

P. R.

Colpe

L. J.

Epstein

J. F.

Gfroerer

J. C.

Hiripi

… Zaslavsky

A. M

. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60, 184–189.

24.

Kessler

R. C.

Berglund

Demler

Jin

Merikangas

K. R.

Walters

E. E.

(2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.

25.

Kessler

R. C.

Birnbaum

Bromet

Hwang

Sampson

Shahly

(2010). Age differences in major depression: Results from the National Comorbidity Survey Replication (NCS-R). Psychological Medicine, 40, 225–237.

26.

Kessler

R. C.

Demler

Frank

R. G.

Olfson

Pincus

H. A.

Walters

E. E.

… Zaslavsky

A. M

. (2005). Prevalence and treatment of mental disorders, 1990 to 2003. New England Medical Journal, 352, 2515–2523.

27.

Mojtabai

Olfson

Sampson

N. A.

Jin

Druss

Wang

P. S.

… Kessler

R. C.

(2011). Barriers to mental health treatment: Results from the National Comorbidity Survey Replication. Psychological Medicine, 41, 1751–1761.

28.

Mulye

T. P.

Park

M. J.

Nelson

C. D.

Adams

S. H.

Irwin

C. E.

Jr Brindis

C. D.

(2009). Trends in adolescent and young adult health in the United States. Journal of Adolescent Health, 45, 8–24.

29.

National Center for Health Statistics. (2009). Health, United States, 2008 with chartbook. Hyattsville, MD: Author.

30.

National Highway Traffic Safety Administration. (2011). Traffic safety facts 2011: A compilation of motor vehicle crash data from the fatality analysis reporting system and the general estimates system. Washington, DC: National Highway Traffic Safety Administration, National Center for Statistics and Analysis, U.S. Department of Transportation.

31.

Neighbors

H. W.

Caldwell

Williams

D. R.

Nesse

Taylor

R. J.

Bullard

K. M.

… Jackson

J. S

. (2007). Race, ethnicity, and the use of services for mental disorders: Results from the National Survey of American Life. Archives of General Psychiatry, 64, 485–494.

32.

Palmer

R. H.

Young

S. E.

Hopfer

C. J.

Corley

R. P.

Stallings

M. C.

Crowley

T. J.

Hewitt

J. K.

(2009). Developmental epidemiology of drug use and abuse in adolescence and young adulthood: Evidence of generalized risk. Drug and Alcohol Dependence, 102, 78–87.

33.

Park

Katon

W. J.

Wolf

F. M.

(2013). Depression and risk of mortality in individuals with diabetes: A meta-analysis and systematic review. General Hospital Psychiatry, 35, 217–225.

34.

Park

Mulye

Adams

S. H.

Brindis

C. D.

Irwin

C. E.

Jr (2006). The health status of young adults in the United States. Journal of Adolescent Health, 39, 305–317.

35.

Pirraglia

P. A.

Hampton

J. M.

Rosen

A. B.

Witt

W. P.

(2011). Psychological distress and trends in healthcare expenditures and outpatient healthcare. American Journal of Managed Care, 17, 319–328.

36.

Pratt

L. A.

(2009). Serious psychological distress, as measured by the K6, and mortality. Annals of Epidemiology, 19, 202–209.

37.

Pratt

L. A.

Dey

A. N.

Cohen

A. J.

(2007). Characteristics of adults with serious psychological distress as measured by the K6 scale: United States, 2001-04. Advance Data, 1–18.

38.

Rickwood

D. J.

Deane

F. P.

Wilson

C. J.

(2007). When and how do young people seek professional help for mental health problems? Medical Journal of Australia, 187, S35–S39.

39.

Roy-Byrne

P. P.

Joesch

J. M.

Wang

P. S.

Kessler

R. C.

(2009). Low socioeconomic status and mental health care use among respondents with anxiety and depression in the NCS-R. Psychiatric Services, 60, 1190–1197.

40.

Shah

B. V.

Barnwell

B. G.

Bieler

G. S.

(1996). SUDAAN user's manual (release 7.0). Research Triangle Park, ND: Research Triangle Institute.

41.

Simon

G. E.

Barber

Birnbaum

H. G.

Frank

R. G.

Greenberg

P. E.

Rose

R. M.

… Kessler

R. C

. (2001). Depression and work productivity: the comparative costs of treatment versus nontreatment. Journal of Occupational and Environmental Medicine, 43, 2–9.

42.

Substance Abuse and Mental Health Services Administration Office of Applied Studies. (2008). The NSDUH report: Serious psychological distress and receipt of mental health services. Rockville, MD: Author.

43.

Substance Abuse and Mental Health Services Administration Office of Applied Studies. (2009). The NSDUH report: Young adults' need for and receipt of alcohol and illicit drug use treatment: 2007. Rockville, MD: Author.

44.

Tanner

J. L.

Reinherz

H. Z.

Beardslee

W. R.

Fitzmaurice

G. M.

Leis

J. A.

Berger

S. R.

(2007). Change in prevalence of psychiatric disorders from ages 21 to 30 in a community sample. Journal of Nervous and Mental Disease, 195, 298–306.

45.

The National Council for Community Behavioral Health Care. (2010). Summary of the Major Provisions in the Patient Protection and Affordable Health Care Act. Retrieved from http://www.thenationalcouncil.org/galleries/policy-file/HC%20Reform%20Bill%20Update-April%207.pdf

46.

U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity: A supplement to mental health: A report of the surgeon general. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services.

47.

U.S. Department of Justice Federal Bureau of Investigation. (2012). Crime in the United States, 2011. Retrieved from http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2011/crime-in-the-u.s.-2011

48.

Vanheusden

van der Ende

Mulder

C. L.

van Lenthe

F. J.

Verhulst

F. C.

Mackenbach

J. P.

(2008). The use of mental health services among young adults with emotional and behavioural problems: Equal use for equal needs? Social Psychiatry and Psychiatric Epidemiology, 43, 808–815.

49.

Wang

P. S.

Lane

Olfson

Pincus

H. A.

Wells

K. B.

Kessler

R. C.

(2005). Twelve-month use of mental health services in the United States: Results from the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 629–640.

50.

Wong

K. O.

Hunter Rowe

Douwes

Senthilselvan

(2013). Asthma and wheezing are associated with depression and anxiety in adults: An analysis from 54 countries. Pulmonary Medicine, 2013, 929028.

51.

J. W.

Adams

S. H.

Burns

Brindis

C. D.

Irwin

C. E.

Jr (2008). Use of mental health counseling as adolescents become young adults. Journal of Adolescent Health, 43, 268–276.