Double whammy? Rural youth with serious emotional disturbance and the transition to adulthood

Statewide Implementation of Parenting with Love and Limits Among Youth with Co-Existing Internalizing and Externalizing Functional Impairments Reduces Return to Service Rates and Treatment Costs

Many community mental health (CMH) systems contain inefficiencies, contributing to unmet need for services among youth. Using a quasi-experimental research design, we examined the implementation of an adapted structural-strategic family intervention, Parenting with Love and Limits, in a state CMH system to increase efficiency of services to youth with co-existing internalizing and externalizing functional impairments (PLL n = 296; Treatment-As-Usual n = 296; 54% male; 81% Caucasian). Youth receiving PLL experienced shorter treatment durations and returned to CMH services at significantly lower rates than youth receiving treatment-as-usual. They also demonstrated significant decreases in internalizing and externalizing symptoms over time. Findings lay the foundation for further examination of the role of an adapted structural-strategic family treatment in increasing the efficiency of CMH systems.

Change and Stability of Emotional Health of Rural Pennsylvania Youth During High School

PURPOSE

Few prior studies have examined change in emotional health of high school students in a rural context. Considering the multifaceted nature of emotional health, this research aims to identify the patterns and explore change and stability of the emotional health of rural Pennsylvania youth. It also investigates the influence of family, peers, school, and the community environment on rural adolescents' emotional health.

METHODS

Using panel data from the Rural Youth Education Project, we employed latent transition analysis to examine changes in patterns of rural students' self-reported emotional health from 9^th grade to 11^th grade (N = 1,294).

FINDINGS

Four distinct emotional health subgroups for rural adolescents were identified. Over half of the youth in the sample felt emotionally well, or positive, in both 9^th and 11^th grades. Roughly 60% of rural youth remained in the same emotional health category from 9^th to 11^th grade, but a substantial minority experienced change in emotional health. One-fifth reported lower emotional health status in 11^th grade, and one-fifth indicated more positive emotions in 11^th than in 9^th grade. We found strong evidence of family, school, community, and peer influences on the emotional health of rural youth in 9^th grade.

CONCLUSIONS

The results suggest that while a large share of rural youth exhibit positive emotional health and remain positive across their high school years, a substantial share of rural youth experience changing emotional health. The study underscores the important role that family, peers, school, and the community environment play for rural youth's emotional health over time.