Informed by relevant literature and combined with demographic, assessment, educational, and service information, program evaluations can identify key factor to manage change. An example follows.

Background. Transition-aged youth (TAY), ages 18 to 26, have higher rates of Substance Use Disorders (SUD) than adolescents or adults over 26 years old. In 2019, 17% experienced a major depressive disorder with 12.1% having severe impairments. Overall, 30.6% experienced mental illness, and 9.7% had serious mental illness. Although TAY reported lower levels of recovery than older adults, predictors of behavioral health recovery for TAY have seldom been explored. Indiana’s Division of Mental Health and Addiction (DMHA) has funded TAY services since 2019 as an effort to positively impact this population.

Methods. Qualitative information from seven currently DMHA funded programs were to support and supplement data analysis. A FFY21 Midwestern sample (n=2575) of treated young adults (ages 18-26) included 688 People of Color (POC; 12% of the sample were Black only, 0.04% Native American only, 0.06% Asian only, 5% other race only, 3% Multiracial, and 6% Hispanic); 0.73% were White only. Half were female. All youth had substance and/or mental health disorders. The Adult Needs and Strengths Assessment (ANSA) identified needs that interfered with functioning and strengths. Transportation, employment, and residential needs were identified early in care. Other need and strength items reflected status when treatment ended.

In a secondary analysis of state-level data, a hierarchical linear regression predicted recovery, the rate of improved Total Actionable Items (Resolved/Ever identified needs). Predictive variables were directly entered into four blocks: 1 (race/ethnicity, gender, employment, transportation, housing stability), 2 (depression, anxiety, substance use [SUD]), 3 (involvement in recovery, SUD recovery support, social functioning, optimism), and 4 (duration of treatment, Motivational Enhancement Therapy [MET). Race was converted to POC and gender to ‘female’.

Results. Each step of the regression model documented significant contributions of added variables (R2s =.013, .239, .319, .350). POC were less likely to improve than white individuals. Women were more likely than men to improve. Individuals with employment, transportation, or housing needs at the beginning of treatment were more likely to improve. Depression, anxiety, and substance use disorders decreased the likelihood of resolved needs. Poor social functioning and inadequate SUD recovery support at the end of treatment were associated with worse outcomes. Having a positive sense of oneself in the future (optimism) predicted recovery. Active involvement in recovery, longer service duration, and Medication Enhancement Therapy were related to higher rates of recovery.

Discussion. In addition to addressing SUD and mental health concerns, young adults’ recovery is related to developmental tasks (employment, recreation, and social relationships), supporting involvement in managing one’s health, and developing resiliency. Attention to social determinants of health, such as transportation, is necessary for access to services and supports. Service adaptations for POC to increase involvement in recovery and equitable outcomes requires consideration and study. Managing change for TAY involves attention to developmental, cultural, behavioral health needs, the concurrent utilization/development of strengths, and monitoring progress.