Youth come to our IL/TL programs with many issues. Some of them can be addressed successfully, like a job or a place to live or acquisition of needed documentation. But many of the youth in our field have significant mental health issues that will be with them for the rest of their lives. What can we possibly do to help these youth, given our limited amount of time and resources? Here are some questions to guide your planning for this vulnerable group of youth:

1. Learn the diagnosis and its implications for you, the youth and your program. How will this diagnosis impact the youth’s transition process? Would the youth do better with others or alone? Will s/he use on-call services more often? Might you need to have a quick back-up plan in place in case the current housing situation doesn’t work? What neighborhoods would work best for this particular youth? What extra supports can we get from the mental health system? Do we have the staff with the training to help this youth? Are we really the best people to work with this youth?

2. Increase client self-awareness about diagnosis. Does the youth understand the symptoms of his/her diagnosis? Has someone gone over thoroughly with the youth the issues that might arise as a result of this diagnosis? Does the youth know the behavior-tolerance limits of the ILP and the plan in place if loss of control is exhibited?

3. Engage MH system providers. Do the Mental Health providers involved (therapists, psychiatrists, etc.) understand the realities of the youth’s IL/TL situation? Do they understand the goals and limitations of the program? Can we help transition this youth into the adult mental health case-management service system? What do we have to do to get him support by this system after s/he leaves us?

4. Expect challenges and setbacks. If this youth goes into a deep depression or manic attack can we keep him where he’s at? If he expresses suicidal thoughts can we support him in the community? If she refuses to take her medications, can we keep her in this living arrangement?

5. Expect self-sabotage. Will this youth act out as a way of showing s/he can’t handle the freedom/responsibility of living more independently?

6. Help youth know personal stressors and triggers. What are the situations and events that cause this youth to act out? Will contact with family members lead to acting out? Can this youth verbally identify things that “set him off”?

7. Maintain a “housing first” approach. If this youth is evicted from her current apartment, can we give her a chance in another place to see if she does better? How can we keep from kicking this youth out of our program’s housing component?

8. Teach self-help. Are there support groups or crisis hotlines this youth can access that might be of help? Is there information this youth needs to read to better understand his issues? Are there peers in our program or natural mentors who could help him through this next stage of his life? Is there a helpful website that this youth could go to learn more about his mental illness?

9. Let youth know limits of program and staff. Does this youth understand office hours, the on-call system, what constitutes an emergency, behaviors that could lead to police being called, behaviors that could lead to discharge from the program?

10. Allow natural consequences if possible. Should we let this youth’s phone be cut off due to too many long-distance calls? Can we let her go two days without food to help her learn to budget her money better?

11. Develop programming one client at a time. Can we write rules and policies that are flexible and allow for occasional acting out, immaturity, relapses, meltdowns and decompensations? Are there supports we can add just for this youth that could buy him some time to work his way out of his current state? Can we make an exception for this youth and let her have a pet, which seems to calm her?

12. Focus on gains and strengths. Would it work better if we focus on what his youth is doing to take care of himself rather than the symptoms of his mental illness?

13. Teach self-acceptance. Can this youth understand that she will always be vulnerable to depression, as it runs in her family? Can we get this youth to understand that his bi-polar disorder can be successfully treated with medication as long as he takes it as ordered?

14. Take a long-range approach. Can we just help this youth find some sense of stability and hope that over the long run, she will understand her mood swings and not be so reactive?

15. Plan on spending more “processing” time. Can we assign this case to someone who will have the time to process things with this youth?

16. Assess for suicide potential. Has this youth ever attempted or threatened suicide before? If yes, what were the circumstances? If we asked him if he currently has any thoughts of suicide or self-destruction, what would he say?

18. Monitor meds. Does this youth have a psychiatrist who has been prescribing and monitoring his response to medication? Can s/he keep the same psychiatrist after s/he leaves our program? Does s/he understand the side effects of this medication and what to do if a dose is missed?

19. Have back up plans in place. Do we understand that youth with mental health issues will almost never follow a transition plan? Do we have a place ready to place this youth if s/he really falls apart? If not, whose job will it be to find a place? Do our landlords and/or resident managers understand that this youth has special issues?

20. Seek out supervision for yourself. Who can I go to for guidance about this particular youth and diagnosis?

21. Allow for “AWOL” youth to return. Can we deal with fact that some of our youth with MH issues might take off and disappear for a while and then return needing help?
Can we take them back into the program if they didn’t leave us on good terms?

Some Helpful Resources

* “Housing Options for Independent Living Programs”
Available at or 202-662-4278 or 800-407-6273

* “Moving In: Ten Successful IL/TL Program Models”
Available at Northwest Media 800-777-6636 or www.northwestmedia.com

* “Transition to Adulthood: A Resource for Assisting Young People with Emotional or Behavioral Difficulties” Brookes Publishing Co.

* “Uncertain Futures: Foster Youth in Transaction to Adulthood” www.cwla.org

* www.mental-health-matters.com

* www.nami.org

• Mental Health Net: http://mentalhelp.net
• SAMSA’s Mental Health Information Center http://www.mentalhealth.org
• National Empowerment Center www.nec.org
• National Mental Health Consumer’s Self-Help Clearinghouse
www.mhselfhelp.org/