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Part 3: Presenting Concerns of Emerging Adults Seeking Treatment at an Early Intervention Outpatient Mood and Anxiety Program

This is part 3 of a 4 part blog series about research done at the First Episode Mood and Anxiety Program (FEMAP) at London Health Sciences Centre (LHSC). FEMAP is a program helping older teens and young adults with emotional concerns which fall into the categories of mood and/or anxiety symptoms. They provide a safe and confidential place for youth to get help early, before symptoms begin to disrupt lives. Research at FEMAP is conducted by researchers at Lawson Health Research Institute and Western University.

In the study from part two of this blog series, young people aged 16-25 who expressed having mood and anxiety concerns were interviewed by researchers to gain insight on their understanding and experience of mental health problems. The study aimed to see if these factors might play a role in why almost half of the young people struggling with mental illness are not seeking help. One of the main gaps found in the participants’ understanding of mental health problems was uncertainty around when a situation might be a normal adolescent experience and/or reaction to life stressors, or whether it was an illness.

Similarly, the study featured in today’s blog seeks further insight from emerging adults (EAs) on what they think the beginning stages of a mental illness might look like and on the uncertainty around when a condition is serious enough to seek professional help. In order to better help EAs when they seek treatment, the researchers involved in this study believed it was key to gain a better understanding of how this age group (16-26) experiences the distress of their mental illness. The way young people communicate their distress when seeking treatment was also vital to their study, and they predicted that EAs would do so by mainly describing functional concerns (e.g. stress about school, problems at work) rather than psychiatric symptoms (e.g. suicidal thoughts, low mood).

The study involved collecting data from over 500 participants (340 females and 208 males, all between the ages of 16-26) during intake assessments for the First Episode Mood and Anxiety Program (FEMAP). Specifically, participants were asked to report what their three biggest life concerns were at that time. These self-reported concerns were then coded and analyzed to find common themes in what the participants shared.

Results showed that the most common concerns had to do with interpersonal relationships (romantic partners, peers, and family), followed by academic concerns, which both far surpassed all other categories. The results also confirmed the researchers’ prediction that participants would report they were seeking help for problems related to functioning and psychosocial issues (which made up approximately 88% of the self-reported concerns) rather than reporting symptoms of mental illness. While overall females were more likely to report relationship concerns, older males and younger females reported these concerns at the highest rate. The second most common category of academic concerns included struggles with coursework, worries about completing post-secondary school, and worries about future post-secondary studies. These concerns were more likely to be reported by females, even when results were broken down by age.

While some participants did report symptoms of mental illness in their top concerns, this was not common. However, when analyzing all participants’ scores for clinical inventories that also took place during the assessment, no factors were found to distinguish between those who reported psychiatric symptoms in their concerns and those who did not. This means that the participants who reported psychiatric symptoms did not necessarily have more treatment experience and the state of their conditions were not necessarily more severe, which suggests that the difference between groups is not directly related to their experience but to the way in which they communicate their distress. It also means that the problems the larger group reported as their biggest concerns (i.e. concerns related to interpersonal relationships and academics) can be generalized to a wider population of EAs seeking help.

Therefore, when a young person refers to relationships and academics as the major problems in their life, this must not be interpreted to mean that they don’t have a major mental health problem. In fact, the authors point out that it is quite the opposite as these are likely to be the most common concerns mentioned by EAs with clinically significant mood and anxiety problems. Additionally, this highlights that EAs who are not seeking help might be struggling to identify whether their distress about problems in day-to-day life is beyond “normal” stress experienced by others during this period of development. The authors also noted that a key factor that distinguishes EAs who are experiencing “normal” stress from EAs that need treatment is the extent that their functioning is impaired. These are all important findings to consider and continue exploring!

To read the previous blogs in this series, follow the links below:

Part 1: Youth Perspectives on What Helps and Hinders Mental Health Treatment

Part 2: Experiences of Adolescents and Young Adults with Mental Health Concerns

You can find more information about FEMAP here, and if you’re interested in looking up the article, you can find the reference information below!

Arcaro, J., Summerhurst, C., Vingilis, E., Wammes, M., & Osuch, E. (2017). Presenting concerns of emerging adults seeking treatment at an early intervention outpatient mood and anxiety program, Psychology, Health & Medicine, 22:8, 978-986, DOI:10.1080/13548506.2016.1248449