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An Essential Education: Mental Health First Aid for Emerging Adults

Valerie English HeadshotAs young adults carve out their place in the world, their new interests and pursuits often push them away from the scaffolding of the familiar – family and high school friend groups – leaving many feeling untethered as they transition to adulthood. Youth who have experienced trauma or identify as part of marginalized populations may be particularly vulnerable.

Psychologist Jeffrey Arnett (2006) identified this pivotal developmental stage from ages 18 to 29 as “emerging adulthood,” characterized by identity confirmation, increasing self-regulation, transition of focus from family to peers and finding one’s place in society. It is a period of self-focus, growth, resilience, possibility and discovery. It can also be a period of instability.

Within this tension between desire for independence and need for connection, leaving behind and moving toward, will for autonomy and nascent self-regulatory skills, societal expectations and developing readiness, lies the risk of mental health challenges.

Emerging adulthood, emerging challenges

One in five adolescents and adults experience mental illness each year. However, this estimate understates the prevalence among emerging adults (Kessler et al., 2012):

    • ○ In any given year, about 40% of emerging adults experience the signs and symptoms of mental illness (Kessler et al., 2005), more than any other age group.
    • ○ The most common mental health disorders experienced by emerging adults are mood disorders (including depression) (22%), substance use disorders (22%) and anxiety disorders (22%). Co-occurrence is common.
    • ○ The onset of 75% of chronic mental health disorders occurs by the mid-20s (Kessler et al., 2007).
    • ○ Among less common mental health disorders, 50% of adults living with bipolar disorder experience their first episode of mania or depression by age 25, and 75% living with schizophrenia experience their first episode of psychosis between the ages of 15 and 30 (Kessler et al., 2005).

Mental health challenges during emerging adulthood can have significant impact — reduced academic and occupational functioning, increased withdrawal from educational pursuits, increased problems with the law, relationship problems and reduced earnings. Unaddressed, they may predict more difficult recovery and delayed ability to thrive while assuming adult pursuits and responsibilities. Mental health challenges affect all domains of life.

The good news is that emerging adults are generally resilient and institutions that engage most emerging adults in the U.S. – institutions of higher learning – offer many resources. Health centers provide counseling for those who reach out for help, while campus groups like Active Minds and Fresh Check Day provide outreach and information.

Still, emerging adults access mental health services less often than any other age group (Kessler et al., 2005), suggesting a need for tools to increase help-seeking. Reasons for avoiding help vary, including perceived lack of need, no time, a choice to manage the challenge themselves, cost and stigma (Czyz et al., 2013). Emerging adults are more likely to discuss what they are experiencing with a peer than with family or a mental health professional, and they are also more likely to seek help when encouraged by someone they know and trust.

Mental Health First Aid can help

For this reason, many institutions of higher learning are offering Mental Health First Aid (MHFA) training to their students. MHFA empowers emerging adults to support one another with training that promotes early intervention for mental health challenges and can remove barriers to care.

MHFA is an evidence-based training that teaches adults ages 18 and older how to identify, understand and respond to signs of mental health and substance use challenges. It does not teach learners how to diagnose or treat mental health challenges; nor is it therapy. Rather, this training provides the skills needed to reach out and provide initial support to someone who may be developing a mental health or substance use problem and help connect them to the appropriate care.

Evidence has demonstrated that successfully completing a MHFA certification increases mental health literacy, increases confidence in reaching out to someone showing signs and symptoms of a mental health challenge, increases awareness of mental health resources within the community and decreases the First Aider’s psychological distress.

I’ve certified students at the University of Connecticut in MHFA since 2016, and each class has filled within hours of notification. Students interviewed for a 2018 article of UConn Today (Enright, 2018) pointed out the value of the training – including learning to identify those who may need help, how to get them help and how to separate the facts about mental health challenges from the myths.

An emerging adult who wants to help their peers needs to recognize the signs and symptoms of a possible mental health challenge, then convey the message, “It’s OK to not be OK. It’s OK to seek help, and here’s where you can find help on campus.”

MHFA provides the tools to do just that – tools to support one another and connect to resources to help navigate mental health challenges. These are especially beneficial given what we know about emerging adults. Regardless of the space they occupy – higher education, the workplace, the military, the community – it may well be essential education.

Register for a MHFA training today.



Arnett, J. J. (2006). Emerging Adulthood: Understanding the New Way of Coming of Age. Emerging adults in America: Coming of age in the 21st century, 3–19. doi: 10.1037/11381-001

Czyz, E. K., Horwitz, A. G., Eisenberg, D., Kramer, A., & King, C. A. (2013). Self-reported barriers to professional help seeking among college students at elevated risk for suicide. Journal of American College Health, 61(7), 398–406. doi: 10.1080/07448481.2013.820731

Enright, M. (2018, March 5). Mental Health First Aid comes to campus. UConn Today.

Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustün, T. B. (2007). Age of onset of mental disorders: a review of recent literature, Current Opinion in Psychiatry, 20(4), 359–364. doi: 10.1097/YCO.0b013e32816ebc8c

Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry, 62(6), 593–602. doi: 10.1001/archpsyc.62.6.593

Kessler, R. C., Demler, O., Frank, R. G., Olfson, M., Pincus, H. A., Walters, et al. (2005, June 16). Prevalence and treatment of mental disorders, 1990-2003. New England Journal of Medicine, 352(24), 2515-2523.

Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. (2012, August 1). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(3), 169–184. doi: 10.1002/mpr.1359

Valerie English Cooper is a biochemist with a long career in medical communications. A National Trainer for the National Council for Mental Wellbeing, she trains and certifies Mental Health First Aid Instructors throughout the U.S. She is also a Mental Health First Aid Instructor, certifying First Aiders for businesses, schools, and organizations primarily in Northeastern U.S.

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