Welcome to bridging the Gap:  Reaching out to Emerging Adults.  Presented by the Café TA Center.

Welcome today in this training we’re going to be talking about emerging adults and how consumers can better link with them and make them part of the broader consumer movement.  Thanks for attending our training let’s get started.

Here are our learning objectives for this training.  They are pretty simple and straightforward.  The first thing we want to do is assist consumers of mental Health Services to identify emerge in youth.  Who are they?  How do you find them?  What are their needs?  Our second objective is to expand outreach that engages youth in consumer directed programs and activities.  And finally, we want to help you assist youth to transition into the consumer community.  So basically, we want a find out who these youth are, find out how to reach them, and find out how consumers can make them part what they’re doing in their communities.

Who are emerging adults and how do we define them?  Generally, the age of emerging adults are between 18 and 25.  This is a time between adolescence and adulthood when young adults are switching from pediatric service system to an adult Service System.  Also, individuals in this age group are at shifting from a school system laden with entitlements to a postsecondary educational environment that thrives on individual capacity.  So both in the Health Care and the educational Arenas there’s a lot more responsibility for individuals in this age group than they were used to as children.

So, what characteristics define a merging adulthood?  Generally speaking, this is a period when individuals begin to naturally push their family and parents away.  That’s part of the process of creating independence and becoming an adult.  It’s also a period of transition when there’s a lot of things changing around the individual.  Finally, it’s a time in which individuals are called upon to make difficult decisions about services, schooling, work finances and personal relationships.  There’s a lot going on in this time period and a lot of the decisions the individual makes will profoundly effect with the rest of their life looks like.

Let’s take a closer look at some of the challenges related to emerging adulthood.  This phase of life poses even greater challenges to those diagnosed with serious mental health conditions.  Those individuals often face unemployment, underemployment, and discrimination based on their condition.  They are overrepresented in Foster care, the juvenile justice system, and school disciplinary cases.  And they also experience the highest level of representation among high school dropouts.  So, clearly there are a lot of challenges related to being an emerging and all with a serious mental health condition.

What adds to this vulnerability?  Several things.  Emerging adulthood is the age of identity exploration.  You need to find out who you are.  People try on different possible identities and have a lot of opportunity to decide who they are going to be in the world.  It’s also a period of instability.  There’s a lot going on.  There’s a lot changing.  The focus is usually on the self during this period.  It’s a period where people feel in between – there are unsettled, they’re not sure where they’re going or who they’re going to end up being.  It’s also a period during which there are a lot of varying possibilities that are both exhilarating and intimidating.  So all of those factors to add to the vulnerability of becoming an emerging adult.

So what happens in the absence of a coordinated system where emerging adults don’t have any help transitioning from the youth and child world to the adult consumer world?  Well, youth and young adults with mental health needs face significant challenges as they age of youth services.  Youth and young adults may be passed on to an inappropriate service tunnel that does not address their specific needs, or they might fall off a cliff – in other words there might not be the service there for adults that they take advantage of as a minor or they might end up with something that doesn’t really fit.  Also, youth and young adults are forced to navigate the complexities associated with the adult service system by themselves, whereas when they are minors there are a lot of systems and people there to help.  When their adults all the responsibility goes back to the individual and that can be a real challenge.

Let’s pause for a moment to think about how some of these movements evolve around different groups.  In the past there have been two parallel movements going on.  There’s been a family movement around children with mental health concerns that’s grown up over the years and there’s also been a consumer movement that’s grown up over the years and that’s a consumer-led movement for adults.  Similarly, there’s been a recent movement towards addressing youth needs; those in emerging adulthood don’t necessarily fit in with the family movement because they the aged out of it, and it’s unclear what their role at this point is in the larger consumer movement that involves adults with a lot more experience in policy decisions and public conversations.  In recent years the youth movement has emerged as a way for this age group, emerging adults, to have a role in creating public policy, raising awareness, and finding a place in the larger conversation about mental illness and substance abuse.

What does some of the research out there tell us about this transition period?  Well, first of all, it tells us that the emotional center during emerging adulthood becomes more complicated as affiliations are made with institutions, fields of study, places of work, and characteristically defined peer groups where the emerging adult may or may not have friends. 

Another thing that’s brought out in the research is that the period between adolescence and adulthood may be further complicated because individuals with mental illnesses are dependent upon their support networks which may disappear altogether or be altered in a manner that may not be adequate for the emerging adult.

Research has also confirmed what you would already suspect that emerging adults leaving pediatric status in the health care system, which is of course when you’re a minor before the age of 18, forces changes in their professional circle of support, the types of professionals that will manage their care.

Continuing with the research about some of the medical challenges, it has often been found that when the new doctor does not conform to roles and behaviors that the emerging adult was used to in a pediatric world, they may feel rejected or confused and miss their pediatric system of care where their family or care coordinators wrapped them with services and supports making it difficult for them to form healthy relationships.

Now that we’ve had a little bit of a conversation about the difficulties facing youth and emerging adults and heard some of the research let’s hear directly from one of those youths themselves. 

Sara:  “I don’t know why, I don’t really need this microphone because on loud enough as it is, I’m sure my mom and Lori can testify to that.  What I wanna say it is –Lori didn’t that look like some of Florida Youth Council staff that we have going on?  Yeah.  The Florida Youth Council which I’m a member of is, we, our ages are a little bit different, 15 to 30, youth and emerging leaders, so I’m 27, yeah!  It’s a group of youth that I joined and I wouldn’t have joined if my mom hadn’t put me on to it.  And, I was the type of teenager who was at home all the time because I have bi-polar disorder and a little bit of anxiety as well, and if… a lot of my teenage and adulthood was spent tagging along with mom.  I wasn’t really independent or anything like that, I was co-dependent.  And whenever, my mom was my biggest advocate’s and I would go with her to Family Café and other working and other presentations and staff issue and go to, conferences, that the word I was looking for, and I would, and she would show me, ‘well why don’t you go to this one, why don’t you go to that one.’  And throughout that I have sort of learned how to use my voice and become a better leader and because, as you were saying, I didn’t have the prom in high school so I feel like I kind of missed out on that I didn’t have…  I had high school homebound for year or two in high school to where I’d talk to them on the phone and that was my high school.  I didn’t really like that that much.  And there’s a high school back home called SCD Severely Emotionally Disturbed.  Mom I don’t think I’m emotionally disturbed do you? And I don’t know, but it’s just the stuff that we go through that you kind of have to learn and…  and it’s just…  You have to find out, learn through doing, and I think that sometimes have to be pushed and sometimes you have to see others doing it and see how much fun it is in order to go out there and do it yourself.  And that’s part of what I do now and when I got out of high school, I didn’t, I went into the college but college just wasn’t for me at the time, so what I did is I took a couple of classes and then I was like, well if you don’t go to college what you do?  You go straight to work.  So I worked at an ice cream shop.  I worked at Target and then that didn’t seem right for me then and I just couldn’t find my niche that was right so I ended up not really doing anything for a while.  And I’ve had different things go on throughout my life experiences over -- I was diagnosed when I was 14 going on 15, and as I said and 27 now.  There’s a book that the Florida Youth Council wrote called Take The World By Storm, so my story is a little too long to tell so it’s in here if end if you’re interested, and were selling these for how much Lori?  $10.00.  So, basically it’s, you need to become your own advocate and that’s part of what I’ve learned.  It’s a tough transition and people don’t want to treat you as equals.  And I really found out that they want to keep treating you as children.  And it a hard thing to do but you need to fight forit.  Its you’re right.  It’s something that you have and you don’t want to let people taken it away from you.  And that’s what I’ve fought for and now I’m going back to school and I’m going to become a social worker.  And I’m going to make sure that people don’t get treated the way that I was treated.  And I’m going to tell you more about that but now I’m going to hand it back over to Conni.”

So what’s the role of consumer leaders in helping youth and emerging adults?  Well, there’s several things that they can do.  They can help them understand the adult System of care.  Help them learn was systems may or may not provide.  It’s often different from what they provide if you’re a minor.  Help youth make contacts within those systems.  Teach them what it means to sell direct services.  Help them develop formal and informal support systems.  Welcome them into advocating necessary services and participating in the public policy conversation.  And also helping them learn how to balance life, mental health needs and work or school.

So what are some of the challenges related to engaging emerging adults?  There are several.  Emerging adults readiness and preparation is difficult.  Sometimes emerging adults already are willing to become part of the adult consumer movement.  Similarly, family readiness to let go can be a challenge.  The parents have been deeply involved prior to the child becoming a youth or emerging adult; might not be ready to let them transition to making decisions for themselves.  It can be hard to locate the emerging adults in your community.  And once to locate them it can also be hard to engage emerging adults.  Another challenge is creating a relevant environment.  You want them to be able to feel comfortable and feel like there something for them in your consumer organization.  Finally, measuring and monitoring outcomes is a challenge.  How do you know how you’re doing?  What’s a reasonable goal?  What is a reasonable target in terms of the number of young adult participants in your program?

What are some of the challenges for emerging adults themselves in relationship to their readiness?  Well, understanding of child and adult system differences is certainly a barrier -- that something that they have to learn and might not be prepared to deal with.  Maturity and independence are often at varying levels from one individual to the next in this age group.  Do they have a support system to help them as they go through this transition process?  Are they prepared individually?  What’s the availability of resources?  Are there any resource is there to help them?  And of course opportunity.  There has to be an occasion or place where they can become part of the adult consumer movement.  In other words, where’s the door?

Conni:  “OK so I’m going to try to repeat the question of and that so they get another recording.  So Charles what you’re saying is that sometimes as youth and emerging adults start this transition they have this new found independence and sometimes they turn their back on mental health services and supports and you’re wanting Sara to talk a little bit about that.  Sara: “I think that sometimes that is not always a good thing because, it’s a good thing and a bad thing, because you need to, there’s a lot of resources out there and you need to find out those resources.  Like, if that person is going to college, there’s always, not always, but there are students with disabled services, and you can get note takers, tutors, and there’s people that can help you get to your class if you’re in a wheelchair.  You need to take advantage of those services. There’s other, like, Voch Rehab, uh, who can help you pay for college, and who can help you get a job.  I mean, it’s hard.  I didn’t want to, you don’t want to be associated with, ‘oh, I have a mental illness, let’s go out and have fun.’  That’s not who I am.  But I learned that I have a voice.  I need to use my voice and I’m glad I got that push for my mom, who is eagerly having a question in the back, I’m glad I got that push from her to join Florida Youth Council, I wish I would have joined two years earlier when she started pushing, but I didn’t, and I am able to use my voice through Florida Youth Council and through other organizations to say use these resources, don’t -- take advantage of them, they’re there why not?

What about families?  What are some of the challenges with their readiness?  Well, all families are different and they’re going to have different levels of readiness at different times.  Some are also more involved than others in the transitioning youth’s health care ongoing struggles.  Some families have been blamed for the child or youth’s mental health issues and that can be a very difficult thing to overcome.  Also, families may spend a lifetime trying to prove that they did a good job.  There’s a lot of guilt there.  They might think that they have to show the world that they did the best they could.  Finally, there are also many points where families are simply not ready to let go and that can be a real challenge for an emerging adult trying to create their own identity and find their own way forward.

What are some of the outside factors that can influence family readiness?  There are several.  Many families have experience with mental health professionals and they’ve shaped their expectations over the years.  For the youth and for the family peers can also create expectations.  There’s a lot of peer pressure and there a lot of notions about what’s appropriate and what’s not appropriate that come from peers outside the family.  Within the family, family members in the extended family can have an influence as well.  They have their own parallel experiences that might be different and might create some expectations.  There also expectations created by the representation of this age group in the media.  We get a lot of our ideas about what’s supposed to be happening between the ages of 18 and 25 from television, movies etc.  Finally, fear and stigma play a significant role.  It’s a scary process to have someone that was a minor member of the family transition to the adult world especially when it’s known that the person has serious mental health challenges.  Finally stigma plays a big role.  It’s hard to let your youth go out into the world knowing that they’re going to face stigma associated with their mental illness.

Slide 22:  What are some of the transition points where youth and emerging adults are moving from the youth world to the adult world?  Well, a major one of course is school.  The secondary education environment and the postsecondary education environment are really different and the type of responsibility is a lot different as well.  There’s also medical transition.  A pediatric system and an adult system are going to have very different expectations.  In the adult system the emerging adult is going to have to take responsibility for their own decisions about their medical care.  The service system.  In many states there are child-specific service systems and adult-specific service systems.  They have different entries, different things available and different rules.  And of course, in the adult system it’s the adult themselves less to manage everything.  Housing.  Of course , this is a time in life when  many people are moving out of their parent’s house and finding housing of their own.  That’s a bit transition.  Finally, transportation.  Everyone knows what it’s like to get a driver’s license and become independent.  That’s a major function of the emerging adult period.  There can be some challenges related to that for those with mental illness and that can be a different transition to manage as well.

What are some of the factors that can influence emerging adults as they move from youth to the adult world?  School and the Individual Education Plan that many youth with disabilities have in public school systems can both be major influences.  The family can be a very big influence, depending on the individual case, and it’s often true that peers are a big influence and that includes both typical peers and other youth with mental health needs.  Another influence might be a professional at within the service system that a youth has dealt with over a long period of time as a minor.  There are images that come out of the media including news, TV, movies, that shape what an emerging adult expects.  And finally fear and stigma play a role.  It can be difficult to transition into adulthood with the fear and stigma that are associated with mental illness.

Sara: “I think with me a was, uh, the mental health groups that the social workers that I had, they were sort of transitioning me from one group to the next and the IEP that I had – I don’t remember, what is an IEP?  I remember what in IEP is, but I don’t even remember going to the last one at that I went to.  And there is fear and stigma.  You’re worried about, ‘oh will it be able to take care of myself, will I be able to have food in the kitchen,’ you’re worried about all this stuff, and you’re kinda worried about ‘oh, should I move out?  What should I do, was the next step?’  And you just don’t know what to do, and that’s why you kind of need people who can help you and who can let you know.”  Conni: “Ty, if you would stand up and I know you’ve been really patient, if you come over here, because I’ll probably call on you again if you don’t mind.  It’s great to have youth, as many youth voices as we can, um, can you talk just for a minute about how professionals and other people other than your family encouraged you to move forward into the adult system.”   Ty : “well actually it’s the reverse, it’s more of a problem, because there’s a cultural barrier.  When I go to a clinician or when I go to a drop in center, the closest person to my age is 40.  They have nothing in common that I do so I have no one to connect to, no one to socialize.  And actually I just really want say something quickly about the family support and peers.  I call that the social support network that they youth don’t have.  Many of our youth who are growing up are either disowned by their family or they disown their family.  And I growing up was not allowed to make friends.  I was going to day treatment centers.  And at a day treatment center, it’s a treatment center, so I’m not allowed to socialize with anyone outside of the treatment center, so I don’t have the same kind of social support network, and that’s a problem, you know, I don’t have friends.  I don’t have, I thank god that I have my mom, but just to say really quickly, that’s a huge problem we have is we have this huge cultural boundary with the people or spouses socialize with, and no one does socialize with, and that’s not good for my mental health.  And as far as, you know, professionals and interactions go, you know, when I turned 17 or 18, the only way I actually manage to work with professionals is when I came to the, uh, when I took control for myself and I said I’m an expert in myself.  That doctor may know everything there is in the book, everything that there is in the DSM5, but he does in a squat about me.  And when it comes down to what my diagnosis is, what my systems are, what medications work for me, I know best, not him.  And it’s a partnership model where he can give me knowledge that I don’t, and I can give him knowledge he doesn’t that works.”

There’s some important challenges for families to consider when they’re letting go of their transition age youth and letting that person become an adult.  There’s a loss of information for the family, and that can be a little bit scary.  Going along with that there’s a loss of control since they are no longer the individuals making the decisions about what’s going to happen, how, where, and when.  There are safety issues.  Many families have been protective of their family member with mental illness.  When that person goes out on their own, they’re concerned about that individual safety.  Then there simply the unknown.  It’s hard to not know what’s going to happen and that’s really tied together with not being in control of what’s going to happen.  Finally, there’s a change in identity.  The whole family structure is different when that youth with a mental illness is not part of the family on a day to day basis anymore.  And there comes to be questions about what the family is, and where it’s going to go going forward.

Now let’s talk about the pass off, when and individual goes from a family-serving system into the consumer-leader system.  First of all, there’s no orientation to the adult system.  There’s nowhere where an individual can go to find out, in one location, from one reliable source, what the adult system is all about.  Often times the gap between the youth and the adult system can seem too large to bridge.  And that’s looking both from the youth perspective and from the adult-consumer perspective.  There’s not really any crossover between the youth-serving and the adult systems.  There’s lack of consistent and predictable coordination.  And of course there are funding silos.  The way the funding works for adult consumer organizations and the way a youth services are funded don’t really crossover.

The way funding is structured can also be a strong influence on the attempts to move youth and emerging adults into the adult system.  The sources that fund consumer networks often have specific requirements about who is the target population for piece of funding.  Sometimes they ahve requirements about what the partners are going to look like in a given grant or contract or cooperative agreement.  There’s also the issue of funding sources.  A lot of times the source of funding will dictate how that funding is going to work, what direction the outreach is going to take, and what the outcomes that are expected are.

The way many service delivery systems are put together, something called “siloing” occurs, that’s what we have our three silos here.  That means that funding goes to specific populations and there’s not really a way that the different programs that serve those populations are linked.  Typically, states will have one source of funding and program set up to serve the child population under the age of 18, then there’s the adult’s silo which serves adult consumers.  And in some cases there are early childhood programs that are intended to serve children between the ages of zero and three.  Note that there’s not usually a youth silo, nor is there a bridge between the children and the adults systems to help those youth move from one to the other.

Now let’s talk a little bit about locating, engaging, and including emerging adults.  There’s some basic questions that every adult consumer program needs to answer if they want to make an effort to engage youth and emerging adults.  You need to know where they are in your community.  You need to know how you’re going to engage them.  And you also need to know how you’re going to include them in your ongoing activities.

Let’s talk about the location where you can find some of these youth and emerging adults that you want to reach out to.  First of all, it’s important that whatever approached you take is both targeted and customized.  It’s not enough to simply use a one-size-fits-all approach or use the same approach that you use when you try to reach out to adult consumers.  You have to think about who your audience is and make sure that you’re doing things in a youth-friendly manner.  You might want to look at a specific population or location when you’re doing your outreach.  Is there a sub-group of youth or emerging adults in your community that you know have a certain activity in common?  Is there a location where you can find them?  Those are questions that might help you identify the right place to go or the right people to ask.  Core activities with variations.  What that means is that you set up a series of activities and invite youth in the community to participate in them.  If you simply have one opportunity for youth and emerging adults to engage with you, you’re not going to have the same type of success you’ll have if you keep that door open while having some consistency in the type of activities you’re offering to the youth and emerging adults.  Whatever you’re doing should be driven by informed input.  That means that the youth and emerging adults themselves should have some input into the types of outreach you’re performing.  If you don’t know what they like, what they need, what they expect, you’re not going to have a very good degree of success.  If you can go out and identify a couple of youth and emerging adults to give you some insight into those questions that will go a long way towards helping.  Finally, whatever you’re doing should be carried out with community it or population leadership.  Youth and emerging adults need to be in the driver’s seat when you crafting your youth outreach programs.  If all the decisions are being made by the adult consumers, the youth aren’t going to feel that there in control or they have a large stake in was going on.  If you allow them to have genuine leadership input and drive the program the program’s going to be more successful and they’re going to be more engaged.

Targeted outreach to emerging adults.  Essentially, when you’re performing outreach you want to make sure you follow these steps in the right order.  The first thing to do is to craft your plan.  That is the strategic planning phase.  That’s when you decide what your approach is going to be, where you’re going to go, how you going to engage, and what you want to get out of it.  Once you have that plan in hand it’s time to actually go out and actually do your outreach, go out into the committee to whatever locations, or sub-populations you identified and see if you can get the youth and emerging adults invested in becoming part of the adult consumer movement.  Finally, enhanced involvement is the last stage.  If you go out and you do succeeded in getting genuine youth and emerging adult input their level of involvement will increase.  Subsequently, it should build a positive reinforcing effect where the more youth you have engaged the more genuine youth input you have, the more successful your future efforts will be, and you’ll have a beneficial reinforcing cycle where you get more and more youth involvement and more and more success in reaching out to those youth and emerging adults in the community.

Part of engaging youth and emerging adults is engaging families.  After all, the families are where the youth and emerging adults are coming from and they can use some help in getting over those barriers that are there in transitioning their family members from the youth system to the adult system.  The role of consumer networks is to educate families on the realities of the adult system.  It’s also helpful to provide resources that can assist in transition from a child to the adult delivery Service System.  Finally, it might be a good idea to participate in family-oriented and conferences.  Those are great locations to connect with the families of young adults and help get the message out that you’re there to help on the adult side when they leave the youth system.

It could also be helpful to develop a training curriculum that helps families formalize their role as supporter of self-direction.  Even if they want to help their family member move from a youth system to an adult system, they might not know exactly how to go about doing that.  If you can create a curriculum to show them how that would definitely help.  It’s also a good idea to contribute regularly to family-oriented activities and events on recovery, self-direction, and the role of families in building their emerging adults capacity to manage their own care.  Again these are all goals that we want for all adult consumers and emerging adults.  If you can participate in family-oriented activities that support those ideals it’s going to give families more confidence that the adult system their aging family member is entering is going to be there to help them.

Here are some tips for engaging emerging adults.  It’s important to guide emerging adults to opportunities.  They might not be aware of what the opportunities are to participate in their community.  If you can help demonstrate what they are for them it would help them become engaged.  Facilitate opportunities for them to be involved with the planning, development, implementation and evaluation of services, programs, and policies.  It means a lot to emerging adults to know that their input is valued and that there’s a role for them in affecting actual real world policy.  That can be a really powerful tool.  Engage them through developmentally appropriate relationships.  It might be appropriate to have someone in your organization serve as a sort of mentor to guide the youth and emerging adults as they become part of the adult service system.  Finally, acknowledge and respect their safety net of support -- that may include parents, family members and other informal and formal key players.  The support network for every youth and emerging adults is going to look a little bit different and it can shift in a pretty short amount of time with all the developmental changes going on during this tumultuous period.  So it’s important to understand that every one of these emerging adults is going to have their own support network and it’s going to be your role to support that.

It’s also important to assist youth and emerging adults in developing personal choice and social responsibility.  Try to enhance competencies necessary to successfully navigate the adult system through social media, training, newsletters, blogs and other methods.  You should also involve emerging adults in organizational efforts at the system, practice, programs and community levels.  On all of these points the idea is to let youth and emerging adults know that they do have a role, that they do have responsibility and that they do have choices to make about what the future is going to look like, both for themselves and for all of their peers with mental illnesses.

Let’s talk about engaging systems and what adult organizations can do to help make a role for youth and emerging adults in the larger picture.  It’s important to advocate for merging adult involvement in the planning, development, implementation, and evaluation of services, programs, and policies.  Adult organizations can serve as a broker of emerging adult involvement.  Finally, try to facilitate the involvement of adult service systems and program representatives with family and emerging adult programs such as the Federation Of Families For Children’s Mental Health and Youth M.O.V.E.

Expect and promote application of consumer-driven practices across the entire age spectrum.  Consumer-driven practices have been part of the adult system for a while now, but the idea of consumer-driven practices being something that is important for youth and emerging adults is relatively new.  Broaden terminology and collaborative partnerships, modeling the recognition of the unique challenges and needs of the emerging adults population.  In other words in other words, you want to make sure that the words you use to describe your agreements include emerging adults as part of the work that is going to be undertaken.

Creating a welcoming environment.  The first step is begin early.  It’s important that you have that plan put together so you know what you want your program to look like, your strategies in place, it’s well thought out, you have given yourself plenty of lead time to implement it.  Recognize the need to respond to the culture of emerging adults.  While emerging adults will have some commonality with your adult consumers, they also have their own unique culture, their own unique ways of communicating, and it’s important that whatever outreach efforts you make take that into account.  Be flexible and adjust as necessary.  If what you’re doing isn’t working don’t be afraid to change it.  Listen to what they say is needed to facilitate their involvement.  This step is really important.  As we said earlier, putting youth and emerging adults in charge of some of these youth outreach activities really make sense.  The more actual authority the youth and emerging adults have, the more invested they’re going to be, and the more successful your organization’s outreach efforts are going to be.  So I really encourage you to take seriously whenever input you get from youth and emerging adults.

One interesting exercise you might choose to undertake this to think about the last event your adult organization hosted.  How do you think emerging adults would view it?  Do think I would appeal to them?  What would you change about it to try to make an appeal to youth and emerging adults?

Let’s recap some of what we talked about during this presentation.  Consumer-leaders play a critical role in the transition of emerging adults into the adult mental health system.  Engagement and inclusion of emerging adults will require strategic and targeted planning and outreach.  Establishing benchmarks will assist in setting goals and measuring outcomes.  Finally, and perhaps most important, the first step is to listen.  We’re really encourage all of you to make an effort to reach out to youth and emerging adults in your community.  They have a lot to say.  They are the next generation of leaders and getting them invested in the conversation now is only going to make our movement stronger in the years to come. 

We hope you’ve enjoyed this presentation.  Please take a moment to complete an evaluation survey by following the link on this slide.  Thanks very much.

This presentation is a production of the CAFÉ TA Center.  The CAFÉ TA Center is supported by SAMHSA to operate one of its five national technical assistance centers providing technical assistance training and resources that facilitate a restructuring of the mental Health System through effective consumer-directed approach is for adults with serious mental illnesses across the country.  Please check out our web site at http://cafetacenter.net.  Thanks very much.