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Static, dynamic, integrated, and contextualized: A framework for understanding mental health service utilization among young adults


  • Munson, Michelle R.
  • Jaccard, James
  • Smalling, Susan E.
  • Kim, Hyunsoo
  • Werner, James J.
  • Scott, Lionel D.


Research has illuminated the problem of untreated mental illness among young adults, including evidence that young people who exit public care systems often discontinue mental health services in adulthood. The present study explored mental health service use experiences during the transition to adulthood among sixty young adults, ages 18–25, from a Midwestern U.S. state. In-depth semi-structured interviews were conducted. All participants had mood difficulties, and shared three childhood experiences: (a) mood disorder diagnosis; (b) use of public mental health services; and (c) experience with social service systems. Immersion and grounded theory coding techniques were applied to the interview data. Two major themes about mental health service use emerged from the findings, namely the changing nature of service use over time and characterizations of experiences associated with service use at a given point in time. Categories of explanatory constructs that emerged in the latter theme included perceived need, emotions, perceived efficacy of services, and social considerations, among others. Findings suggested a four-facet mid-level theory of service utilization, highlighting both the cross-sectional and time-variant character of service use and decision-making within context. Links between broader theoretical frameworks of service utilization and social psychological models of decision making were noted, and guidelines were presented for ten classes of variables that researchers interested in understanding service use by young adults should consider.

Suggested Citation

  • Munson, Michelle R. & Jaccard, James & Smalling, Susan E. & Kim, Hyunsoo & Werner, James J. & Scott, Lionel D., 2012. "Static, dynamic, integrated, and contextualized: A framework for understanding mental health service utilization among young adults," Social Science & Medicine, Elsevier, vol. 75(8), pages 1441-1449.
  • Handle: RePEc:eee:socmed:v:75:y:2012:i:8:p:1441-1449
    DOI: 10.1016/j.socscimed.2012.05.039

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    References listed on IDEAS

    1. Uehara, Edwina S., 2001. "Understanding the dynamics of illness and help-seeking: event-structure analysis and a Cambodian-American narrative of "Spirit Invasion"," Social Science & Medicine, Elsevier, vol. 52(4), pages 519-536, February.
    2. Carpentier, Normand & Bernard, Paul & Grenier, Amanda & Guberman, Nancy, 2010. "Using the life course perspective to study the entry into the illness trajectory: The perspective of caregivers of people with Alzheimer's disease," Social Science & Medicine, Elsevier, vol. 70(10), pages 1501-1508, May.
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    Cited by:

    1. Narendorf, Sarah Carter & Munson, Michelle R. & Levingston, Fredreka, 2013. "Managing moods and parenting: Perspectives of former system youth who struggle with emotional challenges," Children and Youth Services Review, Elsevier, vol. 35(12), pages 1979-1987.


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