YouForward: The Massachusetts Healthy Transitions Program
Abstract: The authors describe how Massachusetts' YouForward program uses Drop-In Centers as a low-barrier pathway to engage vulnerable, hard-to-reach young adults in needed services and supports.
"YouForward: The Massachusetts Healthy Transitions Program" (2019)
Alexis Henry, Jennie Fishman, Betsy Edes, & Susan Wing
Transition-aged youth and young adults with mental health challenges are often derailed from completing school, engaging in work, and establishing adult roles. Because services specific to the needs of young people are often lacking or are poorly coordinated across child- and adult-serving programs, young adults with mental health challenges often "fall through the cracks" in the system at this critical stage of life.1 The Massachusetts (MA) Now-is-the-Time Healthy Transitions project, YouForward, began serving young adults in two diverse communities in northeastern MA in late 2015. Managed by the MA Department of Mental Health in partnership with both child- and adult-serving agencies, YouForward represents an innovative model that bridges the child and adult systems. YouForward staff represent the local communities, which have large Latinx populations. Through strong relationships with other community youth-serving organizations, YouForward engages vulnerable, hard-to-reach young adults by offering low-barrier pathways into services and supports. Specific outreach efforts have brought a number of young adults who identify as LGBTQ, as well as those without stable housing, into the program.
Two Drop-in Centers (DICs) that opened in late 2016 are key to YouForward's low-barrier approach. DICs are available to young adults without any requirement to participate in other services. There are no screening or enrollment processes to enter the DICs; young adults are encouraged to "just walk right in." DICs provide basic amenities such as food and showers, offering young adults a place to meet basic needs and a portal to community resources. DICs also offer young adults an opportunity to join a community, build positive relationships, be inspired by peers, share their voice, and assume leadership roles. For many young adults, DICs are the gateway to other YouForward services.
YouForward's core services include team-based Wraparound services enhanced with the Achieve My Plan (AMP) approach,2 the Transition to Independence Process (TIP),3 Gathering and Inspiring Future Talent (GIFT; a resiliency-focused job training for people with mental health challenges), and access to young adult Peer Mentors.4 YouForward also offers expedited pathways to quickly and easily connect young adults to housing, education, employment, health care, and other services and supports in the community.
To date, YouForward has served over 200 young adults, ages 16 to 25; 53% male, 45% female and 2% non-binary. A number of YouForward young adults identify as LGBTQ. In addition, young parents have found their way to the program. Almost 60% of young adults identify their race/ethnicity as Latino, 24% as White, and 7% as Black/African American. About one-quarter of young adults are bilingual English/Spanish; 64% speak only English, and 11% speak only Spanish.
Assessing YouForward Impacts
We use a mixed-method approach to assess YouForward's impacts, including tracking outcomes achieved by young adults in important areas and conducting focus groups with young adults to understand their perceptions of the program.
Tracking Young Adult Outcomes
Beginning in 2017, we used REDCap,5 a secure web-based application, to build an easy-to-use tracking tool to capture young adults' baseline status and quarterly outcomes in key areas, including education, employment and housing. Data for those enrolled in core services are recorded quarterly in regularly scheduled team meetings.
To date, baseline and outcome data on 68 young adults show gains in education, employment, and housing. At baseline, 43% of young adults were enrolled in school and the majority (81%) had an education goal; typical goals were to complete school or a GED. As of the most recent quarter, 42% of young adults with an education goal had completed it. Also, at baseline, 38% of young adults were working or in a volunteer job; 71% had an employment-related goal. As of the most recent quarter, 51% were working or volunteering. Finally, at baseline, while 68% lived in secure housing, primarily with family, 32% of young adults were living in insecure or temporary housing, and thus were either homeless or at risk for homelessness. At the most recent quarter, 50% of young adults in insecure/temporary housing at baseline had moved into secure housing.
Young Adult Focus Groups
To give voice to their perspectives of the program, two focus groups were conducted with YouForward young adults. Groups took place at one DIC and were facilitated by young adults with lived experience of mental health services; no YouForward staff were present. Twenty-one young adults participated in the groups; 75% had been involved with YouForward for 6 months or more.
During the focus groups, the facilitators emphasized the voluntary and confidential nature of the discussion. Facilitators asked the participating young adults to share their perceptions of the DICs, core services/other activities, and the program overall, and encourage them to share their opinions openly. Groups were audio-recorded and each young adult received $25 to thank them for participating. Audio-recordings were transcribed verbatim and transcripts were analyzed thematically. Data from the focus groups clustered into the following five core themes illuminating young adults' perceptions of YouForward: Services Make a Difference; YouForward Has Changed Our Lives; The Staff Care About and Teach Us; I'm Accepted for Who I Am; and I'm Treated with Respect and My Input Matters.
Programs like YouForward that offer a flexible, low-barrier approach can help young adults struggling with mental health conditions who otherwise have not engaged in services to access the supports they need. The youth-driven practices offered by YouForward and other Healthy Transitions programs allow young adults to make real gains in important areas, such as education, employment, and housing. Such programs provide an opportunity to intervene early during a critical stage and can offer young adults a platform for successful transition to adult life.
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Henry, A., Fishman, J., Edes, B., & Wing, S. (2019). YouForward: The Massachusetts Healthy Transitions Program. Focal Point: Youth, Young Adults, and Mental Health, 33, 5–8. Portland, OR: Research and Training Center for Pathways to Positive Futures, Portland State University.