This convergent mixed method study examines the role of social support in the lives of minoritized emerging young adults with serious mental illness (YA-SMI), focusing on how they perceive and experience support from family, friends, and other sources. Data were gathered from 114 YA-SMI (ages 18–34) participating in a recovery program. Descriptive analyses revealed that 44% of participants reported family as their only source of support, while others relied on a combination of supports or reported no support. Ordinal logistic regression revealed that growing up in a household with mental illness was associated with lower odds of being in a higher support category, compared to no support. Qualitative interviews (n = 57) identified four themes: types of support, qualities of support by source, pathways to treatment, and loss. Findings suggest that YA-SMI benefit from diverse support, with non-family members providing crucial informational support. Implications for policy, practice and research are discussed.
AlversonM.BeckerD.DrakeR. (1995). An ethnographic study of coping strategies used by people with severe mental illness participating in supported employment. Psychosocial Rehabilitation Journal, 18(4), 115–128. https://doi.org/10.1037/h0095476
ArnettJ. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480. https://doi.org/10.1037/0003-066X.55.5.469
4.
ArnettJ. J.ŽukauskieneR.SugimuraK. (2014). The new life stage of emerging adulthood at ages 18-29 years: Implications for mental health. The Lancet Psychiatry, 1(7), 569–576. https://doi.org/10.1016/S2215-0366(14)00080-7
5.
AschbrennerK.Carpenter-SongE.MueserK.KinneyA.PrattS.BartelsS. (2013). A qualitative study of social facilitators and barriers to health behavior change among persons with serious mental illness. Community Mental Health Journal, 49(2), 207–212. https://doi.org/10.1080/01488376.2016.1239595
6.
ATLAS.ti. (2021). ATLAS.ti scientific software development Gmbh. (version 23.2.1) [Qualitative data analysis software]. https://atlasti.com
7.
Ben-DavidS.ColeA.SpencerR.JaccardJ.MunsonM. R. (2017). Social context in mental health service use among young adults. Journal of Social Service Research, 43(1), 85–99. https://doi.org/10.1080/01488376.2016.1239595
8.
BjørlykhaugK. I.KarlssonB.HesookS. K.KleppeL. C. (2022). Social support and recovery from mental health problems: A scoping review. Nordic Social Work Research, 12(5), 666–697. https://doi.org/10.1080/2156857X.2020.1868553
9.
BoothroydR. A.ChenH. J. (2008). The psychometric properties of the Colorado symptom index. Administration and Policy in Mental Health, 35(5), 370–378. https://doi.org/10.1007/s10488-008-0179-6
10.
BraunV.ClarkeV. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3(2), 77–101. DOI:10.1191/1478088706qp063oa
11.
BynumL.GriffinT.RidingD.WynkoopK.AndaR.EdwardsV.StrineT.LiuY.McKnight-EilyL.CroftJ. (2010). Adverse childhood experiences reported by adults-five states, 2009. Morbidity and Mortality Weekly Report, 59(49), 1609–1613. https://doi.org/10.1016/j.amepre.2024.02.010
12.
CaracelliV. J.GreeneJ. C. (1997). Crafting mixed-method evaluation designs. New Directions for Evaluation, 74, 19–32. https://doi.org/10.1002/ev.1069
13.
ChangS.VaingankarJ. A.SeowE.SamariE. Y.luoN.VermaS.SubramaniamM. (2023). Understanding emotion regulation strategies among youths: A qualitative study. Journal of Adolescent Research, 40(1), 44–65. https://doi.org/10.1177/07435584231161002
14.
ChronisterJ.ChouC. C.KwanK. L. K.LawtonM.SilverK. (2015). The meaning of social support for persons with serious mental illness. Rehabilitation Psychology, 60(3), 232–245. https://doi.org/10.1037/rep0000369
15.
ChronisterJ.FitzgeraldS.ChouC.-C. (2021). The meaning of social support for persons with serious mental illness: A family member perspective. Rehabilitation Psychology, 66(1), 87–101. https://doi.org/10.1037/rep0000369
16.
CookJ. A.JonikasJ. A.Burke-MillerJ. K.ArandaF.MullenM. G.DavisM.SabellaK. (2025). Social determinants, mental well-being, and disrupted life transitions among young adults with disabling mental health conditions. The Journal of Behavioral Health Services & Research, 52(2), 1–19. https://doi.org/10.1007/s11414-024-09924-0
17.
CorriganP. W.PhelanS. M. (2004). Social support and recovery in people with serious mental illnesses. Community Mental Health Journal, 40(6), 513–523. https://doi.org/10.1007/s10597-004-6125-5
18.
CresswellJ.Plano ClarkV. (2017). Designing and conducting mixed methods research (3rd ed.). Sage Publications.
19.
CreswellJ.W.Plana Clark, V.L. Gutmann, M.L. Hanson, W.E. (2003). Advanced Mixed Methods Research Designs. In Handbook of mixed methods in social and behavioral research (240th ed., 209). Sage.
20.
CreswellJ. W. (2021). A concise introduction to mixed methods research. Sage Publications.
21.
CurryS. R.AbramsL. S. (2015). Housing and social support for youth aging out of foster care: State of the research literature and directions for future inquiry. Child and Adolescent Social Work Journal, 32(2), 143–153. https://doi.org/10.1007/s10560-014-0346-4
22.
DeVylderJ. E.JunH. J.FedinaL.ColemanD.AnglinD.CogburnC.BarthR. P. (2018). Association of exposure to police violence with prevalence of mental health symptoms among urban residents in the United States. JAMA Network Open, 1(7), Article e184945. https://doi.org/10.1001/jamanetworkopen.2018.4945
23.
EndersC. K. (2001). The impact of nonnormality on full information maximum-likelihood estimation for structural equation models with missing data. Psychological Methods, 6(4), 352–370. https://pubmed.ncbi.nlm.nih.gov/11778677/
24.
FeldmanR. (2020). What is resilience: An affiliative neuroscience approach. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 19(2), 132–150. https://doi.org/10.1002/wps.20729
25.
FelittiV. J.AndaR. F.NordenbergD.WilliamsonD. F.SpitzA. M.EdwardsV.KossM. P.MarksJ. S. (2019). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/s0749-3797(98)00017-8
26.
FettersM. D.CurryL. A.CreswellJ. (2013). Achieving integration in mixed methods designs—principles and practices. Health Services Research, 48(6pt2), 2134–2156. https://doi.org/10.1111/1475-6773.12117
GuettermanT. C.FettersM. D.CreswellJ. W. (2015). Integrating quantitative and qualitative results in health science mixed methods research through joint displays. The Annals of Family Medicine, 13(6), 554–561. https://doi.org/10.1370/afm.1865
29.
HoagwoodK. E.CavaleriM. A.Serene OlinS.BurnsB. J.SlatonE.GruttadaroD.HughesR. (2010). Family support in children’s mental health: A review and synthesis. Clinical Child and Family Psychology Review, 13(1), 1–45. https://doi.org/10.1007/s10567-009-0060-5
HovlandJ. F.LangelandE.NessO.SkogvangB. O. (2023). Experiences of the quality of the interplay between home-living young adults with serious mental illness and their social environments. Issues in Mental Health Nursing, 44(8), 735–745. https://doi.org/10.1080/01612840.2023.2224877
32.
JonesN.GiusB.ShieldsM.FlorenceA.CollingsS.GreenK.WatsonA.MunsonM. (2022). Youths’ and young adults’ experiences of police involvement during initiation of involuntary psychiatric holds and transport. Psychiatric Services, 73(8), 910–917. https://doi.org/10.1176/appi.ps.202100263
33.
KällquistA.Salzmann-EriksonM. (2019). Experiences of having a parent with serious mental illness: An interpretive meta-synthesis of qualitative literature. Journal of Child and Family Studies, 28(8), 2056–2068. https://doi.org/10.1007/s10826-019-01438-0
34.
KaratekinC.AhluwaliaR. (2020). Effects of adverse childhood experiences, stress, and social support on the health of college students. Journal of Interpersonal Violence, 35(1-2), 150–172. https://doi.org/10.1177/0886260516681880
35.
KempS. P.SamuelsG. M. (Eds.). (2019). Theory in social work science. In Science in Social Work (pp. 103–128). New York: Columbia University Press.
36.
LindseyM. A.JoeS.NebbittV. (2010). Family matters: The role of mental health stigma and social support on depressive symptoms and subsequent help seeking among African American boys. Journal of Black Psychology, 36(4), 458–482. https://doi.org/10.1177/0095798409355796
37.
LukensE. P.ThorningH.HermanD. B. (1999). Family psychoeducation in schizophrenia: Emerging themes and challenges. Journal of Psychiatric Practice, 5(6), 314–325. https://doi.org/10.1097/00131746-199911000-00002
38.
MacDonaldK.Fainman-AdelmanN.AndersonK. K.IyerS. N. (2018). Pathways to mental health services for young people: A systematic review. Social Psychiatry and Psychiatric Epidemiology, 53(10), 1005–1038. https://doi.org/10.1007/s00127-018-1578-y
39.
MaleckiC. K.DemarayM. K. (2003). What type of support do they need? Investigating student adjustment as related to emotional, informational, appraisal, and instrumental support. School Psychology Quarterly, 18(3), 231–252. https://doi.org/10.1521/scpq.18.3.231.22576
40.
MastenA. S. (2019). Resilience from a developmental systems perspective. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 18(1), 101–102. https://doi.org/10.1002/wps.20591
41.
McConnellE. A.BirkettM.MustanskiB. (2016). Families matter: Social support and mental health trajectories among lesbian, gay, bisexual, and transgender youth. Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 59(6), 674–680. https://doi.org/10.1016/j.jadohealth.2016.07.026
42.
McKayM. M.HarrisonM. E.GonzalesJ.KimL.QuintanaE. (2002). Multiple-family groups for urban children with conduct difficulties and their families. Psychiatric Services, 53(11), 1467–1468. https://doi.org/10.1176/appi.ps.53.11.1467
43.
MerrickM. T.PortsK. A.FordD. C.AfifiT.GershoffE. T.Grogan-KaylorA. (2017). Unpacking the impact of adverse childhood experiences on adult mental health. Child Abuse & Neglect, 69, 10–19. https://doi.org/10.1016/j.chiabu.2017.03.016
44.
MilesM. B. (1994). Qualitative data analysis: An expanded sourcebook. Thousand Oaks.
45.
MooreG. F.CoxR.EvansR. E.HallingbergB.HawkinsJ.LittlecottH. J.LongS. J.MurphyS. (2018). School, peer and family relationships and adolescent substance use, subjective wellbeing and mental health symptoms in Wales: A cross sectional study. Child Indicators Research, 11(6), 1951–1965. https://doi.org/10.1007/s12187-017-9524-1
46.
MoranE. K.ShapiroM.CulbrethA. J.NepalS.Ben-ZeevD.CampbellA.BarchD. M. (2024). Loneliness in the daily lives of people with mood and psychotic disorders. Schizophrenia Bulletin, 50(3), 557–566. https://doi.org/10.1093/schbul/sbae022
47.
MorelliS. A.LeeI. A.ArnnM. E.ZakiJ. (2015). Emotional and instrumental support provision interact to predict well-being. Emotion, 15(4), 484–493. https://doi.org/10.1037/emo0000084
48.
MorganA. J.RossA.ReavleyN. J. (2018). Systematic review and meta-analysis of Mental Health First aid training: Effects on knowledge, stigma, and helping behaviour. PLoS One, 13(5), Article e0197102. https://doi.org/10.1371/journal.pone.0197102
49.
MosesT. (2010). Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders. Social Science & Medicine, 70(7), 985–993. https://doi.org/10.1016/j.socscimed.2009.12.022
50.
MunsonM. R.BrownS.SpencerR.EdguerM.TracyE. (2015). Supportive relationships among former system youth with mental health challenges. Journal of Adolescent Research, 30(4), 501–529. https://doi.org/10.1177/0743558414554803
51.
MunsonM. R.JaccardJ.Scott JrL. D.MooreK. L.NarendorfS. C.ColeA. R.ShimizuR.RodwinA. H.JenefskyN.DavisM.GilmerT. (2021). Outcomes of a met intervention to improve treatment engagement among young adults with serious mental illnesses: Application of a pilot randomized explanatory design. Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine, 69(5), 790–796. https://doi.org/10.1016/j.jadohealth.2021.04.023
52.
MunsonM. R.JaccardJ. J.ScottL. D.NarendorfS. C.MooreK. L.JenefskyN.ColeA.DavisM.GilmerT.ShimizuR.PleinsK.CooperK.RodwinA. H.HylekL.AmaroA. (2020). Engagement intervention versus treatment as usual for young adults with serious mental illness: A randomized pilot trial. Pilot and Feasibility Studies, 6(1), 1–14. https://doi.org/10.1186/s40814-020-00650-w
53.
MunsonM. R.LeeB. R.MillerD.ColeA.NedelcuC. (2013). Emerging adulthood among former system youth: The ideal versus the real. Children and Youth Services Review, 35(6), 923–929. https://doi.org/10.1016/j.childyouth.2013.03.003
54.
MunsonM. R.NarendorfS. C.Ben-DavidS.ColeA. (2019). A mixed-methods investigation into the perspectives on mental health and professional treatment among former system youth with mood disorders. American Journal of Orthopsychiatry, 89(1), 52–64. https://doi.org/10.1037/ort0000326
55.
MuthénB. O.MuthénL. K.AsparouhovT. (2017). Regression and mediation analysis using Mplus. Muthén & Muthén.
56.
Office of the Surgeon General. (2021). Protecting youth mental health: The US surgeon general’s advisory. US Department of Health and Human Services.
57.
OkpychN. J. (2024). Estimating a national college enrollment rate for youth with foster care histories using the National Youth in Transition Database (NYTD): Limitations of NYTD and a call to revise and relaunch. Journal of Public Child Welfare, 18(1), 21–46. https://doi.org/10.1080/15548732.2022.2153961
58.
OluwoyeO.StokesB. I.BurduliE.KriegelL. S.HoagwoodK. E. (2023). Community-based family peer navigator programme to facilitate linkage to coordinated specialty care for early psychosis among Black families in the USA: A protocol for a hybrid type I feasibility study. BMJ Open, 13(7), Article e075729. https://doi.org/10.1136/bmjopen-2023-075729
59.
PadgettD. K. (2016). Qualitative methods in social work research (Vol. 36). Sage Publications.
60.
PalinkasL. A.AaronsG. A.HorwitzS.ChamberlainP.HurlburtM.LandsverkJ. (2011). Mixed method designs in implementation research. Administration and Policy in Mental Health, 38(1), 44–53. https://doi.org/10.1007/s10488-010-0314-z
61.
PettitJ. W.RobertsR. E.LewinsohnP. M.SeeleyJ. R.YaroslavskyI. (2011). Developmental relations between perceived social support and depressive symptoms through emerging adulthood: Blood is thicker than water. Journal of Family Psychology, 25(1), 127–136. https://doi.org/10.1037/a0022320
62.
PooleJ. C.DobsonK. S.PuschD. (2018). Do adverse childhood experiences predict adult interpersonal difficulties? The role of emotion dysregulation. Child Abuse & Neglect, 80, 123–133. https://doi.org/10.1016/j.chiabu.2018.03.006
63.
RosenbergA. R.BrownC. E.RosaW. E.JoyceP. (2023). When resilience is cliche and resilience resources are taboo: How language and policies exacerbate mental health disparities. The Lancet. Child & Adolescent Health, 7(4), 236–237. https://doi.org/10.1016/S2352-4642(23)00005-6
64.
SabellaK. (2021). Factors that hinder or facilitate the continuous pursuit of education, training, and employment among young adults with serious mental health conditions. Psychiatric Rehabilitation Journal Rehabilitation Journal, 44(4), 373–380. https://doi.org/10.1037/prj0000470
65.
SapiroB.QuirozS. R. (2022). Authenticity, vulnerability, and shame in peer relationships among marginalized youth living with mood and anxiety disorders. Journal of Child and Family Studies, 31(11), 3192–3208. https://doi.org/10.1007/s10826-022-02358-2
66.
SapiroB.WardA. (2020). Marginalized youth, mental health, and connection with others: A review of the literature. Child and Adolescent Social Work Journal, 37(4), 343–357. https://doi.org/10.1007/s10560-019-00628-5
67.
SaundersB.SimJ.KingstoneT.BakerS.WaterfieldJ.BartlamB.BurroughsH.JinksC. (2018). Saturation in qualitative research: Exploring its conceptualization and operationalization. Quality and Quantity, 52(4), 1893–1907. https://doi.org/10.1007/s11135-017-0574-8
68.
ScalesP. C.BensonP. L.OesterleS.HillK. G.HawkinsJ. D.PashakT. J. (2016). The dimensions of successful young adult development: A conceptual and measurement framework. Applied Developmental Science, 20(3), 150–174. https://doi.org/10.2307/3350341
69.
ScarderaS.PerretL. C.Ouellet-MorinI.GariépyG.JusterR. P.BoivinM.TureckiG.TremblayR. E.CôtéS.GeoffroyM. C. (2020). Association of social support during adolescence with depression, anxiety, and suicidal ideation in young adults. JAMA Network Open, 3(12), Article e2027491. https://doi.org/10.1001/jamanetworkopen.2020.27491
70.
ShernD. L.WilsonN. Z.CoenA. S.PatrickD. C.FosterM.BartschD. A.DemmlerJ. (1994). Client outcomes II: Longitudinal client data from the Colorado treatment outcome study. The Milbank Quarterly, 72(1), 123–148. https://doi.org/10.2307/3350341
71.
ShulmanS.KalnitzkiE.ShaharG. (2009). Meeting developmental challenges during emerging adulthood: The role of personality and social resources. Journal of Adolescent Research, 24(2), 242–267. https://doi.org/10.1177/0743558408329303
SmithM. E.LindseyM. A.WilliamsC. D.MedoffD. R.LuckstedA.FangL. J.DixonL. B.Lewis-FernándezR. (2014). Race-related differences in the experiences of family members of persons with mental illness participating in the NAMI family to family education program. American Journal of Community Psychology, 54(3), 316–327. https://doi.org/10.1007/s10464-014-9674-y
74.
SteinC. H.AguirreR.HuntM. G. (2013). Social networks and personal loss among young adults with mental illness and their parents: A family perspective. Psychiatric Rehabilitation Journal, 36(1), 15–21. https://doi.org/10.1037/h0094742
75.
Substance Abuse and Mental Health Services Administration. (2024). Key substance use and mental health indicators in the United States: Results from the 2023 national survey on drug use and health (HHS publication no. PEP24-07-021, NSDUH Series H-59). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/data/report/2023-nsduh-annual-national-report
76.
ThoitsP. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52(2), 145–161. https://doi.org/10.1177/0022146510395592
77.
ThomasE. C.SnethenG.SalzerM. S. (2017). A developmental study of community participation of individuals with serious mental illnesses: Implications for policy and practice. American Journal of Orthopsychiatry, 87(5), 597–605. https://doi.org/10.1037/ort0000269
78.
ToporA.BorgM.MezzinaR.SellsD.MarinI.DavidsonL. (2006). Others: The role of family, friends, and professionals in the recovery process. Archives of Andrology, 9(1), 17–37. https://doi.org/10.1080/15487760500339410
79.
TracyE. M.MunsonM. R.PetersonL. T.FloerschJ. E. (2010). Social support: A mixed blessing for women in substance abuse treatment. Journal of Social Work Practice in the Addictions, 10(3), 257–282. https://doi.org/10.1080/1533256X.2010.500970
80.
TurnerR. J.BrownR. L. (2010). Social support and mental health. In ScheidT. L.BrownT. N. (Eds.), A handbook for the study of mental health: Social contexts, theories and systems (2nd ed., pp. 200–212). Cambridge University Press.
81.
UmbersonD.Karas MontezJ. (2010). Social relationships and health: A flashpoint for health policy. Journal of Health and Social Behavior, 51(1_suppl), S54–S66. https://doi.org/10.1177/0022146510383501
82.
UngarM.GhazinourM.RichterJ. (2013). Annual research review: What is resilience within the social ecology of human development?The Journal of Child Psychology and Psychiatry and Allied Disciplines, 54(4), 348–366. https://doi.org/10.1111/jcpp.12025
83.
UngarM.TheronL. (2020). Resilience and mental health: How multisystemic processes contribute to positive outcomes. The Lancet Psychiatry, 7(5), 441–448. https://doi.org/10.1016/S2215-0366(19)30434-1
84.
Van DroogenbroeckF.SpruytB.KeppensG. (2018). Gender differences in mental health problems among adolescents and the role of social support: Results from the Belgian health interview surveys 2008 and 2013. BMC Psychiatry, 18(1), 1–9. https://doi.org/10.1186/s12888-018-1591-4
85.
Van ParysH.BonnewynA.HoogheA.De MolJ.RoberP. (2015). Toward understanding the child’s experience in the process of parentification: Young adults’ reflections on growing up with a depressed parent. Journal of Marital and Family Therapy, 41(4), 522–536. https://doi.org/10.1111/jmft.12087
86.
WashingtonK. T.Bickel-SwensonD.StephensN. (2008). Barriers to hospice use among African Americans: A systematic review. Health & Social Work, 33(4), 267–274. https://doi.org/10.1093/hsw/33.4.267
87.
WernerE. E.SmithR. S. (1992). Overcoming the odds: High risk children from birth to adulthood. Cornell University Press.
88.
WilliamsT. R.WalkerT. L.WyattW. N. (2022). Conceptualizing racism through a systemic trauma lens: Impacts on Black college students. Journal of Psychotherapy Integration, 32(1), 49–63. https://doi.org/10.1037/int0000206
89.
World Health Organization. (2018). Adverse childhood experiences international questionnaire.
90.
ZimmermanM. A. (2013). Resiliency theory: A strengths-based approach to research and practice for adolescent health. Health Education & Behavior: The Official Publication of the Society for Public Health Education, 40(4), 381–383. https://doi.org/10.1177/1090198113493782
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
