The most recent revision of the Individuals with Disabilities in Education Act (IDEA) mandates that students’ strengths be considered in the transition planning process for students with disabilities; however, there is evidence that individuals’ strengths are not being utilized to support their transition to adulthood (Shogren & Plotner, 2012; Landmark & Zhang, 2012). Strengths refer to all of an individual’s assets, both personal and contextual, that improve that individual’s ability to function (Davis et al., 2007; McCammon, 2012). Parents have unique perspectives of their sons’ and daughters’ strengths (Carter, Brock, & Trainor, 2014) and have the potential to influence the transition planning process in a positive way. This study used qualitative methods to understand how parents describe their son or daughter’s strengths, both personal and contextual, in relation to transition planning. Findings indicated that parents identify equal amounts of personal and contextual strengths for their children. However, strengths were described as being context dependent; the trait or resource described as an asset in one aspect of transitioning to adult life was also described as a barrier to another aspect. These findings highlighted the value of including parents in the transition planning process and that students have many strengths available for consideration as they enter adult life.

Transition-age youth with mental health conditions experience adverse employment and educational outcomes and little is known about strategies for improving their outcomes. The purpose of this study was to review education and employment intervention programs that targeted transition-age youth with mental health conditions, to highlight the components, efficacy of the interventions, and predictors of better outcomes. Eighteen studies published between 1990 and 2017 met the inclusion criteria. Results indicate that interventions led to improvement in employment or education outcomes. Common intervention components included: mental health services, career counseling, career development, cognitive adaptation training, interagency collaboration, peer mentoring, functional skills assessment, individualized or person-centered counseling, social skill, and independent living skills training. Being married, active participation in vocational intervention, social support, prior work experience, high score on Social and Occupational Functioning Assessment Scale were found to be associated with better education and employment outcomes. Implications for research, and practice are discussed.

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As educators and higher education administrators, it is important that we connect to our students. It serves us well to learn the stories behind those beautiful eyes looking back at us, as we support their navigation through the journey of higher education. This thesis, written in a Scholarly Personal Narrative (SPN) style, will use former foster youth students, as well as at-risk youth, as the population of focus. I will relay my own personal experiences, as a former youth-in-care. I will also explore this kind of alternative upbringing, to draw closer to the conclusions and insights of the struggles and triumphs of this population's journey through higher education. I will show how the successful connections with supportive administrators, friends, and family lead to a successful student and improved human being upon graduation. When we label our marginalized students as "at-risk" we are imposing a story upon them, that is not theirs. This stereotypes where they came from dismisses their stories, and triumphs, and places them in a box that labels them. We need to provide them the same opportunities and supports that other students get to help make their way into and through college. We must remove the label of "at-risk" but this is only part of the journey in supporting these young people while they progress toward a degree. It is our job to increase success through weaving together opportunities to connect with different departments, different leaders on campus, and different groups of their peers. From the classroom, to our offices and hallways, this will help these students to create a stronger view of themselves and the world. As a former youth in foster care, I am not at-risk. I am at-promise. All the vulnerable young adults that I talk about in this thesis are not "at-risk." Instead, they are 'at-promise.'

Background Youth and young adults represent a critical time for early detection and intervention of serious mental health conditions (SMHCs); however, of all age groups, health care use is lowest in young adults. Continued access to health services such as outpatient primary care and specialized mental health care, especially during the transition from pediatric to adult care, is important to improving outcomes in those with serious mental health conditions. Methods Stakeholder engagement and a mixed-method design were used. Quantitative Aims 1 and 2 used the IBM MarketScanCommercial Database. Qualitative Aim 3 used semi-structured interviews with a purposive sample of pediatricians and child/adolescent psychiatrists. Stakeholders were engaged throughout all Aims to ensure relevance of goals, real-world interpretation of results, and dissemination of key findings. Aim 1 described patterns of outpatient (e.g., primary, reproductive, mental health care) and acute (e.g., emergency room use, inpatient hospitalization) health care use by age, and serious mental health condition for youth and young adults. Aim 2 used logistic models with generalized estimating equations to identify factors associated with mental health follow-up after hospitalization and emergency room use for a serious mental health condition. Aim 3 explored pediatrician and child/adolescent psychiatrist perspectives on coordinated care for youth and young adults with serious mental health conditions, particularly as they transition to adult care. Main Results The prevalence of outpatient mental health care and primary care decreased with age, with a larger drop in primary care utilization. While 74.0-78.4% of those aged 12-17 years used both outpatient mental health care and primary care, 53.1-59.7% of those aged 18-27 years did. Differences were observed by mental health condition; those with schizophrenia and other psychotic disorders had the lowest rates of outpatient primary care use and the highest rates of acute care use. Of those hospitalized, 42.7% received follow-up within 7 days and 64.7% within 30 days. Of those with emergency room use not resulting in a hospitalization, 28.6% received follow-up within 7 days and 46.4% within 30 days. Having established mental health care strongly predicted follow-up, and more so than having established primary care. Providers described poor communication systems, no organized process for the transition from pediatric to adult care, a lack of time and reimbursement, and inadequate connection to community supports as key barriers to continuous, coordinated care for youth with serious mental health conditions. Conclusion Findings provide foundational knowledge to inform efforts to provide a comprehensive continuum of care for people with serious mental health conditions, potentially through increased access to primary care and specialized mental health care via enhanced care coordination of providers.