American teens lose access to mental health care at 18 – with disastrous results

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Age 18 is a particularly difficult time for a person to drop out of — or lose access to — mental health services. Those age 18 to 25 are more likely than the general adult population to report having serious mental illness, having serious thoughts of suicide, or to have attempted suicide. And as is the case across much of the U.S. population, the suicide rate for young adults has risen in recent years, climbing 76% between 2007 and 2017.

Even when teens are able to make the jump to adult mental health care, the actual care they receive can look very different from what they’re used to with pediatric psychiatry. That, too, can be jarring — and discourage young people from keeping up with their care.

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“There’s a big disconnect between the pediatric psychiatry world and the adult psychiatry world,” [psychiatrist Mark] Schechter said.


In an ideal world, experts said, it would be easier for mental health providers — particularly those at outpatient and inpatient facilities that only treat children — to keep seeing patients until age 21 or even older. Some children’s mental health centers and providers already do that, or will at least keep 18-year-old patients on until they graduate.

Mental health providers should be talking early, and thoroughly, with parents and teenagers about what the transition will look like. There shouldn’t be a cliff — there should be a bridge.


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