Mental health care for young adults

Only about half of U.S. young adults with a mental health condition (49.1%) got mental health treatment in 2022. Many people wait years before asking for help, often hoping things will pass on their own.

For early psychosis, for example, NIMH describes coordinated specialty care: a team approach where specialists, the person and their family make decisions together, with a focus on recovery.

In a few short years, many young adults leave home, start college or work, change friend groups, and take charge of their own health for the first time. The brain also keeps maturing into the mid-to-late 20s.

Times to pay extra attention

• A breakup or the loss of a close friendship
• Exam periods or a first demanding job
• Losing a parent’s health plan or moving away from your doctor
• Moving to a new city, school or country
• The first months after high school or college ends

Everyone has down days. But feeling sad, empty or numb most of the day, nearly every day, for two weeks or more is different. You might lose interest in things you used to love, sleep too much or too little, feel exhausted, or struggle to focus. In 2024, 15.9% of U.S. young adults had a period of serious depression in the past year.

What helps

• Regular sleep and meals
• Small daily actions, even when motivation is low: a short walk, a shower, a message to a friend
• Talking therapies, such as CBT, which help you notice and shift unhelpful thought patterns
• Telling someone you trust how you are really doing

With so much uncertainty, worry is common in young adulthood. It becomes a concern when it is hard to control, lasts for months, or makes you avoid classes, work, people or places. Panic attacks, social fears and constant “what ifs” are all common experiences.

What helps

• Cutting back on caffeine and alcohol, which can make anxiety worse
• Facing fears in small, gentle steps instead of avoiding them
• Slow breathing and grounding to calm the body’s alarm
• Therapy approaches like CBT and ACT

Some people have periods of unusually high energy, little need for sleep, racing thoughts or risky choices, followed by deep lows. Across the world, mood conditions most often begin around age 20.

What helps

• An early check with a clinical provider if swings are intense
• Keeping a steady daily routine, especially sleep
• Talking therapy and family support
• Tracking sleep, mood and energy to spot patterns

Psychosis means losing some contact with what is real. People may hear voices, feel watched, or hold strong beliefs others don’t share. It often begins in the late teens to mid-20s; schizophrenia is usually first diagnosed between ages 16 and 30. Subtle changes in thinking, mood and social life often come first.

Early signs can include

• A drop in grades or work
• Feeling suspicious or uneasy around others
• Pulling away from friends and family
• Trouble thinking clearly
• Unusual ideas or strong feelings that don’t fit the situation

Early help matters. Coordinated specialty care is a team approach to early psychosis, where specialists, the person and their family make decisions together, with a focus on recovery.

Struggles with food and body image often start in the teen years and early 20s. Worldwide, about 82% of people with these difficulties first experience them before age 25. They can affect anyone, of any size, gender or background.

Signs to notice

• Constant worry about weight or shape
• Eating in secret, or feeling out of control around food
• Exercising even when sick or injured
• Strict rules about food, or skipping meals

Skills to practice

• If you have a therapist, ask how to keep care going if you move for school or work
• Keep your insurance card and doctor’s contact details in your phone
• Know your own health history, allergies and any ongoing treatment
• Practice booking your own appointments and refills
• Write down questions before a visit

Got Transition’s Six Core Elements include assessing self-care skills, creating a transition plan with a medical summary, transferring to an adult practice, and confirming the move is complete.

Ask your current provider for

• A short summary of your health history and current care
• A copy of any care or safety plan you made together
• Names of adult providers they trust
• Help sending your records to the new practice

Moving away can mean leaving a therapist or doctor behind. Some therapists can keep seeing you by video, but licensing rules differ by state. Ask before you move, so there is no gap in care.

Before you leave

• Ask your current provider about options in your new area
• Check whether your insurance works where you are going
• Find the campus counseling center or a local clinic
• Save crisis numbers in your phone

Under U.S. law, young adults can generally join or stay on a parent’s health insurance until age 26. For job-based plans, this is true even if you marry, have a child, start or leave school, live away from home, aren’t claimed as a tax dependent, or turn down job-based coverage of your own.

Good to know

• A parent can add you during their plan’s open enrollment, or after certain life changes
• On a parent’s Marketplace plan, coverage can continue through December 31 of the year you turn 26
• Some employers or states allow coverage past 26. Check with the plan or your state’s Department of Insurance.

If you are on a parent’s job-based plan, coverage usually ends during or shortly after the month you turn 26. You get a Special Enrollment Period that starts 60 days before you lose coverage and ends 60 days after. If you enroll before your old coverage ends, your new plan can start the first day of the following month.

Your options may include

• A catastrophic plan, mainly for worst-case costs, if you are under 30
• A Marketplace plan, with possible savings based on income
• A student health plan, if you are in school
• Coverage through your own job, which you can usually join outside open enrollment after losing a parent’s plan
• Medicaid or CHIP, depending on income and situation. You can apply any time of year.

All Marketplace plans must cover mental health and substance use services as essential health benefits, including counseling and psychotherapy. Plans can’t refuse you or charge more because of a mental health condition you already have.

Under “parity” rules, limits on mental health care, like copays or visit caps, generally can’t be stricter than limits on medical and surgical care.

Federal law lets most young people who aged out of foster care, and were on Medicaid at that time, keep Medicaid until age 26. There is no income test. For youth who turned 18 on or after January 1, 2023, this coverage follows them even if they move to another state.

Good to know

• In an emergency where there is a serious and imminent threat to your safety or others’, providers may contact family who can help
• Providers can always listen to concerns from your family, even when they can’t share back
• Providers can share with family involved in your care if you don’t object
• You decide who can be told about your care

Health conversations with a provider are private and won’t be shared without your permission, except in the situations above.

Many young adults choose to sign a form letting a trusted parent or friend talk with their care team. You can limit what is shared, and you can change your mind later.

Things to think about

• How much you want them to know: everything, or just appointments and safety
• What you would want them to do in an emergency
• Who you trust most to stay calm and respect your choices

If you are on a parent’s insurance, the plan may send statements to the main policyholder that list visits. If privacy matters to you, call the plan and ask how statements are sent and what options you have.

In the 2024–2025 Healthy Minds Study of more than 84,000 college students, about 37% had received therapy or counseling in the past year. Among students with depression or anxiety symptoms, about 60% got some kind of mental health care.

Campus options often include

• Disability or accessibility offices for study adjustments
• Peer support and wellness programs
• Short-term counseling and group sessions
• Student health centers that can refer you

Places to try

• Community mental health centers, often with sliding-scale fees
• Employee assistance programs (EAPs) at work
• FindTreatment.gov or the SAMHSA Helpline (1-800-662-4357)
• Training clinics at universities, where supervised trainees offer lower-cost therapy
• Your primary care provider, who can refer you

Your health plan may also have a list of mental health providers who take your insurance.

Many therapists and clinics offer sessions by video or phone. This can help if you live far from services, don’t have a car, or work odd hours.

Tips

• Check that the provider is licensed in the state where you are
• Find a private spot, like a parked car or a room with a fan running
• Have a backup plan if the connection drops
• Use headphones for privacy

Talk therapy can be provided by psychologists, psychiatrists, social workers, counselors and psychiatric nurses. Many therapists blend approaches depending on their training and what you need.

Groups like NAMI and Mental Health America share information on finding a professional, but they don’t check individual providers, so look up licenses yourself.

Try asking

• How will we know if this is working?
• How often would we meet, and for how long?
• What approach do you use, and why?
• What happens if I don’t start to feel better?
• What will each visit cost me?

You can also ask for a second opinion, or about other options, if a suggestion makes you uneasy.

Rapport and trust are an important part of therapy. A short first conversation can help you see how treatment would work and whether you feel comfortable.

Ideas

• Help them find out what their insurance covers
• Offer a ride to an appointment, or sit with them while they make a call
• Research campus or community options together
• Remind them gently about insurance deadlines, like turning 26

Once your child is 18, you may not be able to see their health records or talk with their providers without their permission. You can still share your concerns with their provider, who can listen even if they can’t share back.

Ways to stay connected

• Ask if they would be willing to sign a form letting you talk with their care team
• Let them make choices you might not make, unless safety is at risk
• Talk about a plan for emergencies before one happens

Try saying

• “I’ve noticed you seem really tired lately. How are you doing?”
• “Lots of people your age talk to someone. It doesn’t mean something is wrong with you.”
• “Would you like help finding someone to talk to?”
• “Whatever you decide, I’m on your side.”