Mental health narratives matter for marginalized young people

"...young adults who are marginalized do not feel heard, respected, and helped by professional mental health providers." A narrative approach could remedy that.

Research demonstrates the value of eliciting the patient’s perception of a physical condition, also known as the “illness narrative,” as a valuable tool for improving health management.

If you’ve ever suffered a chronic illness, or loved someone who has, you probably wondered what caused it. And the way you thought about the origins of the problem—based on past experiences and choices made—probably differed from the way your physician approached it, with laser focus on the presenting symptoms.

Over the past decade, Michelle Munson, associate professor at New York University’s Silver School of Social Work, has been examining the narratives of young adults with mental health challenges. She and her colleagues, principally Sarah Narendorf of the University of Houston, have found that improving mental health for young people will require serious respect and consideration for how each individual makes sense of their condition and its origins.

“The point is: how these young people are thinking, and feeling, about the condition matters.”

Questions to ask a young adult include: What do you think caused your condition? How do you think it is best managed? Do you think professional treatment can help? What do you perceive would be the consequences of not getting help? “The individual’s interpretation of their mental health is something that patients and practitioners need to uncover—together—as part of a therapeutic relationship,” explains Munson. “This is critical to keeping young adults invested in their own healing.”

These empirical studies focus on marginalized young adults: defined by the Institute of Medicine as navigating added challenges in their transition to adulthood, including poverty, reliance on safety-net systems of care, disabilities, and young parenthood.

As the data suggest, how young adults make sense of their symptoms, how they feel about them, and their perceptions of help sources all strongly influence their engagement (or lack thereof) with treatment, and how well they will continue to take care of themselves.

For now, Munson and Narendorf, along with their colleagues, have proposed in a newly published article in the American Journal of Orthopsychiatry, and another forthcoming in the Journal of the Society for Social Work and Research, that there can be a transformation in mental health if we can train providers to closely consider these narratives.

Here they explain their ongoing research:

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