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2014 Toolkit

Youth and Young Adults

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The physical, mental, and emotional health of youth (ages 12-17) and young adults (ages 18-25) are essential to every family and community.  When young people exhibit signs of mental and substance use disorders, it is important that they receive appropriate support as early as possible.  Family members, friends, and trusted adults (e.g., teachers, schools counselors, and medical professionals) can help by understanding the risks and learning about the resources to help young people with behavioral health conditions.

Every September, the Substance Abuse and Mental Health Services Administration (SAMHSA) (, within the U.S. Department of Health and Human Services (HHS) (, sponsors National Recovery Month (Recovery Month) to increase awareness of behavioral health conditions.  This observance promotes the belief that behavioral health is essential to health, prevention works, treatment is effective, and people recover from mental and substance use disorders.

The 25th annual Recovery Month theme, “Join the Voices for Recovery:  Speak Up, Reach Out,” encourages people to openly discuss mental and substance use disorders and the reality of recovery.  It aims to foster public understanding and acceptance of behavioral health conditions, including ways to help young people in need of prevention, treatment and recovery support services.  The mental health and substance abuse recovery community can encourage young people to play a role in speaking up by sharing their experiences and rising above peer pressure.  They can reach out by helping themselves or a peer who might be in need.

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Speak Up…

Statistics highlight the importance of supporting youth and young adults in avoiding the risks of developing a mental and/or substance use disorder, as the data shows the widespread prevalence of mental and substance use disorders:

  • Among adults reporting a mental, emotional, or behavioral disorder during their lifetime, more than half report that the disorder started in childhood or adolescence.1
  • The percentage of young adults 18 to 25 (6.8 percent) who have a co-occurring mental illness and substance use disorder was the highest among adults age 18 and older.2
  • Binge drinking and heavy alcohol use peaks between people aged 18 to 25, with nearly 40 percent of adults aged 18 to 25 reporting binge drinking and 13 percent reporting heavy alcohol use.3
  • In 2012, the average age of initiation of illicit drug use among people aged 12 to 49 was 18.7 years.  Additionally in 2012, there were about 2.9 million people aged 12 or older who used an illicit drug for the first time, and more than half of these initiates were younger than age 18.4
  • Nonmedical use of prescription psychotherapeutic drugs is highest among young adults aged 18 to 25 compared to adults 26 or older and youth 12 to 17, with 5 percent of adults aged 18 to 25 reporting nonmedical use in the past month, compared to 2 percent of those 26 or older reporting nonmedical use in the past month and about 3 percent of those aged 12 to 17 reporting nonmedical use in the past month.5

It is more important now more than ever to speak up on behalf of young people.  Reaching young people benefits individuals, families, and communities.  Similarly, promoting the social, mental, physical, and emotional well-being of youth leads to:6

  • Higher productivity;
  • Better educational outcomes;
  • Lower crime rates;
  • Lower health care costs;
  • Improved quality of life; and
  • Improved family life.

Good health begins with prevention and this starts with building awareness of the signs and symptoms of behavioral health conditions.  In fact, the first symptoms of a mental and/or substance use disorder typically precede the condition by two to four years.7  Everyone should learn the symptoms below so they can help identify if they are experiencing a behavioral health condition, or if they know someone who may have one or more symptoms.

Signs of a mental health problem may include:8,9

  • Feeling very sad or withdrawn for more than two weeks;
  • Showing signs of confusion and an inability to follow directions;
  • Having unusual ideas and experiencing paranoia;
  • Responding to hallucinations;
  • Seriously trying to harm oneself or commit suicide, or making plans to do so;
  • Experiencing sudden overwhelming fear for no reason, sometimes with a racing heart or fast breathing;
  • Showing severe behavior that can hurt oneself or others;
  • Not eating, throwing up, or using laxatives to lose weight;
  • Having intense worries or fears that get in the way of daily activities;
  • Experiencing extreme difficulty controlling behavior, putting oneself in physical danger or causing problems in school;
  • Using drugs or alcohol repeatedly;
  • Having severe mood swings that cause problems in relationships;
  • Showing drastic changes in behavior or personality;
  • Feeling tired or having problems sleeping; and
  • Loss of interest in activities once enjoyed. 

Signs and symptoms of a substance use problem may include:10

  • Sudden weight loss;
  • Loss of interest in favorite activities and/or pastimes;
  • Chronic coughing;
  • Sudden drop in grades;
  • Uncommon behavior problems at home and school;
  • Skipping school or class;
  • Change in friends;
  • Stealing;
  • Excessive hunger;
  • Runny nose; and
  • Loss of appetite.
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Reach Out…

When reaching out to youth and young adults, let them know they are not alone.  Many resources are available to support young people in places they frequent most, such as at school or community groups, at home and with friends.  Young people can confide in a trusted teacher, counselor, or other staff member at their school or university.  They can also reach out to a coach or community group or faith leader who is influential in their lives to get the support they need and help them succeed.  Trusted adults can help young people find treatment and recovery support options that meet their needs.

Often, youth and young adults go to their peers for support, which is why it is critical to learn how to talk to a friend who may be experiencing a behavioral health condition.

If a friend is showing signs of a mental health problem, young people can:

  • Express concern and support;
  • Find out if your friend is getting the care he or she needs and wants – if not, connect him or her to help;
  • Ask questions, listen to ideas, and be responsive when the mental health problems come up;
  • Offer to help your friend with everyday tasks;
  • Include your friend in your plans – continue to invite him or her without being overbearing, even if he or she resist your invitations;
  • Educate other people so they understand the facts about mental health problems and do not discriminate; and
  • Treat him or her with respect, compassion, and empathy. 

If a young person suspects their friend has a substance use disorder:11

  • Talk to your friend when he or she is not intoxicated;
  • Convey your concern for your friend’s well-being with specific, factual statements on their behavior;
  • Openly discuss the negative consequences of your friend’s alcohol or substance use;
  • Emphasize the difference between sober behavior that you like and behavior under the influence of drugs or alcohol that you dislike, but be sure to distinguish between the person and the behavior;
  • Encourage your friend to consult with a professional to talk about his/her substance use problem.  You can offer to help them locate resources or go with them to an appointment.  As resources, use SAMHSA’s treatment locator ( or treatment referral hotline ( – 1-800-662-HELP (4357) or 1-800-487-4889 (TDD); and
  • If you have a friend or family member you really trust, talk to them about your friend’s behavior.  Their involvement may help.

Remember to let youth and young adults know there is no shame, only courage and honesty, in asking for help or reaching out to a person in need.

High school students in recovery can consider enrolling in a recovery high school, established to provide students with a safe and substance-free environment conducive to sustaining recovery.  The Association of Recovery Schools ( provides a listing of recovery high schools nationwide.  College-age students can join a student support group or attend a recovery activity or workshop on campus.  One campus option to consider is Collegiate Recovery Communities (CRCs), which provide enrolled students at the college or university treatment, counseling support, a peer support system, as well as a safe drug and alcohol-free space for students in recovery.12  Many universities have peer educator programs that provide educational and support services to students.  Recovery Inclusive Prevention Strategies ( is another helpful resource that seeks to link students in recovery with opportunities to be involved in peer to peer school based prevention programs.  You can locate college recovery programs on The Stacie Mathewson Foundation’s Recovery Support Map (

Youth and young adults, as well as their mentors, friends, and families, can turn to online resources for support and engagement, including:

It is equally important for someone with a loved one struggling with a behavioral health condition to seek the support they need, such as with counseling groups like Al-Anon/AlaTeen (

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Make a Connection…

To connect with youth and young adults, start by choosing a setting where they will be comfortable learning new information, such as a school or university assembly.  Use the following tips to initiate your efforts:

  • Find out if you or your organization is ready to engage youth.  Take a readiness assessment ( and structure your outreach goals and activities based on the assessment.
  • Talk with other organizations in the community that have already successfully partnered with youth and young adults for their advice on how to engage.
  • Research existing, federally-supported youth programs in your community at Map My Community (  You can filter your search by looking for programs that deal with substance use disorders, bullying, mental health, homelessness and housing, and health and nutrition.
  • Develop key talking points on prevention, treatment, and recovery relevant to youth and young adults in your community.
  • Reach out to school or university officials to plan time or guest-speaking opportunities to educate students about prevention, treatment, and recovery support services.
  • Talk to parents of youth during a parent-teacher night or open-house at local schools school, and teach them ways to discuss mental and/or substance use disorders with their kids, including how to recognize warning signs.
  • Ask coaches, professors, or teachers to integrate information about mental and/or substance use into their conversations with their students or athletes.  Consult the “Mental and Substance Use Disorders:  Fast Facts” ( document in this toolkit for more information.
  • Be respectful of people’s time – parents, teachers, and coaches may have full schedules.  Offer to meet at a time that is most convenient for them.

Additional resources for youth and young adults, and their family members and friends are provided in the “Targeted Outreach Resources” ( section of the toolkit.

Inclusion of websites and resources in this document and on the Recovery Month website does not constitute official endorsement by the U.S. Department of Health and Human Services or the Substance Abuse and Mental Health Services Administration.

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  1. National Research Council & Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Committee on the Prevention of Mental Disorders and Substance Abuse among Children, Youth, and Young Adults: Research Advances and Promising Interventions. O’Connell, M .E., Boat, T., & Warner, K. E. (Eds.) Board on Children, Youth, and Families, Division of Behavioral and Social Sciences and Education. Washington, DC: National Academies Press.
  2. Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-47, HHS Publication No. (SMA) 13-4805. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 46.
  3. Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013. Retrieved on November 12, 2013, from NationalFindings/NSDUHresults2012.htm#ch3.1.1.
  4. Substance Abuse and Mental Health Services Administration, Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.
  5. Center for Behavioral Health Statistics and Quality. (2012). Results from the 2011 National Survey on Drug Use and Health: Detailed tables. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved November 12, 2013, from
  6. U.S. Department of Health and Human Services. (n.d). Myths and Facts. Retrieved on September 9, 2013, from
  7. The National Academies. (2009). Preventing Mental, Emotional, and Behavioral Disorders among Young People Progress and Possibilities. Retrieved September 9, 2013 from, p. 1.
  8. U.S. Department of Health and Human Services. (n.d). For Parents and Caregivers. Retrieved on September 9, 2013, from
  9. WebMD. (n.d.). What is Depression. Retrieved on December 5, 2013, from
  10. (2013). Teen Drug Abuse. Retrieved on September 9, 2013, from
  11. Brown University. (n.d.). Talking to a Friend About Drinking or Drug Use. Retrieved September 25, 2013, from
  12. Kennesaw State University. (n.d.). Collegiate Recovery Community (CRC). Retrieved September 9, 2013, from

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