INTRODUCTION
Recent statistics on the mental health of young adults in South Korea have revealed the severity of their mental health issues. In 2018, 10.4% of the South Koreans in their 20s and 12.4% in their 30s received mental illness treatment. By 2022, these rates had increased to 14.0% and 13.8%, respectively, with 20-year-olds showing the largest increase of 3.6 percentage points [1]. Additionally, suicide has been the leading cause of mortality among young adults in the same age groups [2]. In 2022, the rate of experiencing mental health issues over the past year was 72.4% for individuals in their 20s and 71.1% for those in their 30s in South Korea. These figures are significantly higher than those of other age groups [3]. In particular, 20-year-olds accounted for 19.0% of all patients with depression [1,4], demonstrating the urgent need for social awareness and multifaceted management of mental health issues among young adults.
Young adulthood is a transitional period in life during which young people must accomplish critical developmental tasks such as choosing a career path, preparing for employment, and establishing independent social relationships. Mental vulnerability is increased by the complex stress factors that arise during this process [5]. Furthermore, this is also the period when severe mental illnesses such as schizophrenia, depression, and bipolar disorder first manifest. Without early detection and appropriate interventions in the initial stages, these conditions can become chronic or lead to severe functional impairments [6]. Psychiatric issues such as depression, schizophrenia, and suicidal behaviors account for 45% of the total years lost due to disability (YLDs) in this age group [7]. This suggests that mental illness in young adults is not simply a personal problem but rather requires a systematic approach at the public health level for early detection and intervention [6].
Furthermore, social distancing measures and increased noncontact activities implemented during the COVID-19 pandemic have significantly worsened social isolation and anxiety among young adults [8]. Concurrently, protracted social and economic crises in South Korea, including employment instability, high unemployment rates, and poverty, have exacerbated the mental health risks faced by young people [9]. To effectively address mental health crises among young people, it is imperative to establish a systematic mental health service system that provides early diagnosis and intervention for mental disorders.
In the past, mental health services for young people in Korea were limited to being part of mental health programs for adults [10]. However, with the enactment of the Youth Basic Act in 2020, social interest in mental health issues among young people and support for mental health policies have expanded [11]. The government has also announced innovative mental health policy measures, including specific details such as shortening screening cycles, strengthening early intervention, and continuing its policy efforts to support the mental health of young people [10]. In 2012, the Early Intervention Project was initiated as a core task of the Mental Health Pilot Project in Gwangju Metropolitan City. In 2016, it was launched as the Youth Mental Health Center (YMHC) under the brand name "Mind Link" in response to the growing need for youth mental health services in youth-friendly independent spaces. Since then, the YMHC has expanded to 17 cities and provinces nationwide as part of the efforts to strengthen policies targeting youths [12]. The YMHC provides youth-tailored mental health services aimed at preventing mental illnesses through early intervention for young people struggling with mental health issues and supporting recovery through appropriate treatment and management [4]. The target population for these YMHCs includes young adults aged 19~34 years who require community-based mental health services, specifically those with first-episode mental illnesses within five years of onset, those at high risk for psychosis, and those diagnosed with early psychosis [4]. A variety of mental health services are offered at the YMHC, including telephone, online, and face-to-face counseling. Intensive case management is also provided to help young people to actively engage in social interactions and quickly return to their daily lives [12]. While specialized services, such as YMHCs, are expanding in response to the seriousness of youth mental health issues that have emerged in recent years, the actual effectiveness of such services needs to be supported by empirical evidence. The utilization rate of mental health services among young people in South Korea is only 16.2%, which is significantly lower than that in Canada (46.5%), Australia (34.9%), and Japan (20%) [3]. The low utilization rate is attributed to factors unique to the youth generation, such as concerns about stigma and negative social perceptions, concerns about the impact of mental health records on employment, and a tendency to downplay mental health issues, which act as significant barriers to accessing mental health services [13]. To overcome these limitations and establish an effective mental health service support system for young people, it is necessary to gain a deep understanding of the specific experiences of young people who use these YMHCs from their perspective. In addition, it is essential to understand the practical significance and changes that the YMHCs' services bring to their lives. Previous research on mental health services for young adults has been limited to quantitative studies on factors influencing such services [9,11], the model and utilization status of early intervention programs at these YMHCs [12], qualitative studies on case management experiences of individuals with early psychosis [14], and the help-seeking process from young adults' perspectives [15]. Reflexive thematic analysis (TA) is a qualitative research method that, instead of focusing on causality from a positivist viewpoint, emphasizes processes and meanings through the researcher's reflexivity. This method recognizes the complexity and contradictions of experience, aiming for deep understanding rather than just simple description. Therefore, this study employs reflexive TA [16], focusing on the interaction between participants' experiences and interpretations to thoroughly explore the meaning of YMHC utilization from young adults' perspectives, rather than that of policy and service providers. By applying reflexive TA to explore the experiences of young adults who use YMHC from their perspective, psychiatric mental health nurses can better understand the complex needs of young adults with mental health issues, as well as their preferences and barriers to using the center. It is essential for nurses to deliver interventions tailored to the developmental stage and needs of young adults based on this understanding.
METHODS
1. Research Design
A qualitative research design was adopted using reflexive thematic analysis, as outlined by Braun and Clarke [16], to gain an in-depth understanding of young adults' experiences of mental health problems at the YMHC. This study followed the consolidated criteria for the reporting of qualitative research (COREQ) checklist [17].
2. Participants
The participants were young adults registered at the YMHC in Jeonbuk province who were utilizing the YMHC's services. The following criteria were used to select study participants: young adults aged 19~34 years (based on the YMHC's registration criteria) utilizing the YMHC's services, voluntarily agreed to participate in the study in writing after hearing the purpose and explanation of the study, and were able to sufficiently express their experiences verbally. Those with severe psychiatric symptoms (e.g., anxiety or depression) that prevented them from participating in the interviews were excluded. The participants were recruited using a purposeful sampling method. A recruitment notice was posted on the program information bulletin board at J* YMHC located in J* province. Upon seeing this notice, seven participants voluntarily expressed their intention to participate in the study. Subsequently, three additional participants were selected using a snowball sampling method, where the initial participants recommended other participants, resulting in a total of 10 participants. This number represents the point at which the researcher determined that no new interview content or themes emerged during the process of conducting in-depth interviews and analyzing the data, indicating data saturation. None of the participants in this study refused to participate or dropped out during the study.
3. Researcher Preparation
The researcher is a certified psychiatric mental health nurse practitioner with over 10 years of experience in a mental hospital and more than 5 years in case management and program operation at community mental rehabilitation facilities and mental health welfare centers. The researcher is currently involved in mental health promotion projects at a regional mental health welfare center. Through projects aimed at enhancing mental health awareness, the researcher has become aware of the significant mental health challenges faced by young people. To conduct qualitative research and gain a deeper understanding of qualitative research methodology, the researcher reviewed the related literature, attended two workshops, and an online lecture on the subject. Additionally, to acquire data collection and analysis techniques for reflective thematic analysis, the researcher conducted preliminary interviews and data analysis practice sessions and reviewed the process through feedback from a supervising professor.
4. Ethical Considerations
This study was approved by the Institutional Review Board (IRB) of the researcher's affiliated institution (JBNU 2024-04-026-003). Before participating, all participants received a written explanation of the study, including details of its purpose, procedures, audio recording, confidentiality, data protection, and storage. Written informed consent was obtained after a verbal explanation. Participants were informed of their right to withdraw at any time without penalty. All data were anonymized, stored securely, and accessible only to the researchers. A small monetary incentive was provided to the participants upon the completion of each interview.
5. Data Collection
The data collection for this study was conducted from July 18 to October 31, 2024. The data collection method primarily involved one-on-one in-depth interviews; participants' nonverbal expressions were observed and recorded during the interviews. The interviews were conducted at times and locations convenient for the participants, primarily in quiet cafes near their homes or in counseling rooms at Centers where privacy could be ensured. Each participant was interviewed one to two times, with each session lasting between 60 and 90 minutes. The average interview duration per participant was approximately 70 minutes. All interview contents were recorded using the voice conversion application Clover Note (ver. 2.4.0), with participants' consent. At the beginning of the interviews, the researcher introduced themselves to build rapport with the participants, and then surveyed their general characteristics before conducting individual interviews using a semi-structured questionnaire. The interview began with introductory questions such as "How have you been spending your days lately?" The interview questions included open-ended questions, such as "Please tell us about your experience in utilizing the YMHC," which allowed the participants to share their experiences freely. As the interview progressed, the researcher asked questions such as "How did you first come to the YMHC?" "What experiences did you have while using the YMHC?" "What is the importance of these experiences to you?" "What changes did you experience while using the YMHC, and what remained unchanged?" "What aspects of using the YMHC were helpful?" "What aspects of using the YMHC are challenging?" These questions were designed to understand the meaning of the participants' experiences with the YMHC. To gain a multifaceted understanding of the participants' experiences, the researcher listened carefully to their words and recorded their nonverbal behaviors and responses in detail in the interview notes. After the first interview, follow-up sessions were held if needed, focusing on clarifying or expanding the topics that emerged during the initial interviews.
6. Data Analysis
The audio-recorded individual interviews were transcribed verbatim using the voice-to-text application Clover Note (ver. 2.4.0). Computer-assisted qualitative data analysis software Parangsae 2.0 was utilized for qualitative data management and analysis. Data were analyzed following the six-phase process of reflexive thematic analysis proposed by Braun and Clarke [16]. Reflexive TA primarily uses researcher subjectivity as a tool. One of the main assumptions of reflexive TA is that the researcher's subjectivity is not a problem to be managed, but rather a resource to be utilized in the analysis [16]. In line with this assumption, researchers engage in self-reflection by writing memos or journals to understand their own beliefs, values, assumptions, and attitudes that could influence the research process, and then conduct the analysis. The first step was to familiarize ourselves with the data. Within 48 hours of the interviews, we listened to the recorded data and read the transcribed content to understand the participants' statements. The second step involved generating preliminary codes related to the research questions, resulting in 210 codes derived from the analysis of meaningful data. The third step involved grouping codes with similar meanings to explore initial themes, generating 18 initial themes based on the 210 codes. The fourth step was reviewing the original data to determine if there was sufficient evidence supporting the initial themes, leading to ten subthemes. The thematic analysis process, including codes, initial themes, subthemes, and themes, is presented in Figure 1. The fifth step was to redefine and refine the themes to reveal their meanings, resulting in four organized themes. In the sixth stage, we repeatedly reviewed the original data to select representative sentences that expressed each theme, capturing their meanings and contexts.
7. Rigor of the Study
To enhance the rigor of this study, we conducted the research based on the criteria of credibility, transferability, dependability, and confirmability, proposed by Lincoln and Guba [18]. First, to ensure credibility, the researcher confirmed the interview content with the participants during the interviews and verified whether the participants' statements and the meanings of their experiences aligned with the researcher's understanding. Interview data were recorded and transcribed verbatim using the voice-to-text application Clover Note (ver. 2.4.0). The transcribed data were then analyzed using the computer-based qualitative data analysis software. The researcher reviewed the transcribed data, underlined meaningful raw data, created a preliminary code list, reviewed the coded text to develop an initial codebook, and applied it to the transcripts of additional participants. Additionally, the researcher reflected on perspectives and biases that could influence the interviews and analysis and conducted a member check process with three participants to confirm that the analysis results accurately reflected their experiences. To ensure transferability, we described the participants' characteristics and the context in depth so that the research results could be sufficiently utilized in similar situations or contexts, thereby increasing the applicability of the results in various contexts. The researcher underwent an external audit in which two qualitative researchers evaluated the researcher's interpretations and results based on the data. The researcher maintained a neutral stance and sought to understand participants' experiences. Additionally, each step of the reflective thematic analysis method proposed by Braun and Clarke [16] was reviewed to ensure that the analysis was conducted based on actual data.
RESULTS
The participants included seven women and three men, with a mean age of 26.9 years. Their jobs/engagements ranged from being self-employed (n=1), working in an office (n=1), college students (n=3), and seeking employment (n=5). Their duration of using the YMHC's services were 11.8 months. Eight participants had received psychiatric diagnoses, including moderate depressive episodes, schizophrenia, and other anxiety disorders. The remaining two had not received official diagnoses, but were experiencing mental health issues. After case conferences and discussions at the YMHC, they were considered eligible for services and registered as members (Tables 1, 2).
Theme 1: Reconnecting with the World and Seeking Change
Before using the YMHC, participants suffered from depression and helplessness for a long time because of repeated failures and frustrations in their daily lives. However, not wanting to be cut off from the world, they sought help and learned about the YMHC. Participants experienced having their pain understood through the YMHC, and, together with peers facing similar concerns and difficulties, attempted to reconnect with the world through change.
Subtheme 1: Seeking breakthrough solutions to overcome frustration
Before using the YMHC's services, participants faced issues such as workplace maladjustment, resignations, conflicts with colleagues, repeated failures in job searches, and difficulties adapting to school life. These ongoing frustrations caused deep feelings of helplessness and depression to the point that even basic self-care, such as maintaining personal hygiene, became difficult. Participants reported lying in bed all day, being unable to leave their homes, and seeing themselves as worthless. However, over time, they showed a growing desire to seek help to escape their helplessness. While some visited the YMHC based on recommendations from family or friends, most participants found it on their own through online searches.
I thought I'd take it easy for a while-read some books or play games-but I didn't do any of that. I just stayed in bed. In the beginning, even going outside was scary. (…) I seriously couldn't do anything (Participant 3).
I was just so overwhelmed, so depressed-I wanted to die. It felt like I couldn't go on anymore. (…) I think that's when I started thinking, I need to do something, anything, to change this (Participant 9).
Subtheme 2: Seeking a refuge to be understood
Participants expressed a strong need for a "refuge" where they could be genuinely understood and supported. Because their families often saw their struggles as a lack of willpower or personal weaknesses, their home environments no longer felt safe or comforting. Due to feelings of shame and fear of judgment, participants found it difficult to share their inner experiences with others. Over time, they began to recognize their mental health issues through repeated episodes of depression and challenges in their relationships. However, concerns about social stigma and negative perceptions made them hesitant in seeking hospital-based treatment. When they finally received psychiatric diagnoses at hospitals that they had reluctantly visited, they described feeling intense despair and a profound sense of denial about their condition. Importantly, the fear of friends or peers discovering their struggles prevented them from confiding in anyone.
My parents noticed that I wasn't doing well, but they didn't believe I was seriously ill. They thought it was something I could handle on my own. (…) (Participant 4).
At first, it didn't feel very comfortable. (…) 'Why me? Why would I have a mental illness?' I felt ashamed, as if I couldn't accept it. (…) I felt like I wasn't good enough, like something was seriously wrong with me (Participant 5).
Subtheme 3: Desiring a connection with the peer world
Participants expressed a strong desire to connect with their peers by socializing with others of their age. In the absence of individuals with whom they could share their feelings openly, they reported a growing need for opportunities to engage with peers of the same age and share their concerns and struggles. Many participants who had spent long periods in isolation and were unable to engage in external activities because of persistent feelings of helplessness and depression expressed renewed interest in participating in experiences they had previously missed, such as cultural activities, hobbies, and sports, while utilizing the YMHC's services.
I started seeing my friends less and less, and I had to do most things alone. I didn't have many friends, and I wasn't part of any group. (…) I didn't have any of that. (...) I did try going to other centers, but the age ranges were so mixed that it was hard to connect with anyone (Participant 1).
I wanted to make friends. It's nice to have a lot of friends. (...) I ended up dropping out of college after I got sick while attending. And back then, it was during COVID, so I couldn't even meet anyone (Participant 6).
Theme 2: Journey of Recovery that Began Together
By utilizing the Center's services, participants encountered peers who had experienced similar struggles. These encounters naturally fostered mutually supportive and encouraging relationships, which enabled participants to gradually emerge from feelings of helplessness and gain confidence in their ability to recover. As their confidence improved, they began to slowly regain the rhythm of their daily lives, which had previously deteriorated. Furthermore, they developed a concrete understanding of the significance of their mental health challenges and the importance of treatment-issues they had previously recognized only vaguely-thus initiating their journey toward recovery.
Subtheme 1: Being together in support and encouragement
Participants described developing supportive relationships by meeting their peers with similar concerns at the YMHC. They expressed their deep gratitude for the sincere listening and emotional comfort they received from others. Through these conversations, the participants not only regained confidence but also developed the ability to objectively reflect on one another's experiences. In addition, they reported a sense of belonging and relief stemming from the belief that they could always return to the YMHC and receive support whenever they encountered difficulties in daily life.
It felt like I had entered a group of young people I could belong to. I wanted that sense of belonging. It felt like we were tightly connected-like a strong bond, you know? It gave me a sense of security.(…) (Participant 1).
Even without explaining every little detail, just a look from someone was enough to comfort me. I felt more relaxed, and I realized that others were going through similar things-it wasn't just my struggle. (Participant 8).
Subtheme 2: Rebuilding a shattered daily life
The participants reported positive changes as they gradually restored their daily routines. Those who previously showed little interest in personal hygiene started to care more about their appearance through interactions at the YMHC. Participation in group programs and self-help meetings helped them become more comfortable talking to different people. This encouraged them to reconnect with friends with whom they had grown apart. Unlike their earlier feelings of helplessness, the participants described being able to recognize their current situation and independently develop plans for change. They implemented these plans slowly but steadily, taking proactive steps toward recovery.
The biggest change was my appearance. Back then, I didn't even shower, I barely ate, and I just let my hair grow out... (…) Now I go out to take pictures, go for walks, and even exercise. These were things I did before, and now I've started doing them again (Participant 3).
The most important change for me was that I started going outside. (…) so I ended up going out at least twice a week. And being around other people - it turned out to be pretty nice, actually (Participant 7).
Subtheme 3: Starting to improve with professional help
Participants gradually developed hope for recovery through support from the YMHC. Consultations with psychiatrist helped them understand their conditions. Individual counseling with case managers and participation in therapeutic programs also aided in recognizing symptoms and shifting negative thoughts to more positive perspectives. Participants who hesitated to seek help due to financial constraints received necessary evaluations and began treatment without hesitation, thanks to support for treatment costs. Additionally, they learned about various youth support policies from the YMHC, which helped them start and maintain their recovery journeys.
While going through the program, I learned what depression is, and I had a lot of questions about the side effects of the medication. (…) Hearing other people's stories also helped me reflect on my problems (Participant 3).
I receive an allowance, but I'm expected to cover all my living expenses with it, making hospital bills a big burden. (…) If I also had to pay for the hospital, I probably wouldn't have been able to go (Participant 4).
Theme 3: Obstacles Still to Overcome
While participants made progress through the YMHC, they still faced significant challenges. Many reported lingering fears about recurring symptoms such as depression and helplessness, and doubted the possibility of full recovery. Although they recognized their efforts and ongoing improvements, they hoped that others would see and accept these changes. However, the outside world still felt indifferent and unwelcoming. Additionally, practical difficulties encountered during the use of the YMHC created obstacles in the recovery process.
Subtheme 1: Changes occurring more slowly than expected
Participants continued to experience anxiety and fear due to the slower-than-anticipated pace of recovery despite noticing positive changes. Daily life stressors and challenges in relationships often trigger feelings of depression and helplessness. Some expressed concerns that their prolonged reliance on the YMHC signaled a delay in recovery. Others described feeling overwhelmed by memories of past failures or depressive episodes, and hesitated to share their deepest thoughts. While acknowledging their gradual progress, the participants also expressed ongoing worries about relapse, along with a complex mix of hope and anxiety about future changes.
I'm doing well right now, but I keep wondering-if I stop taking my meds, will everything come back? (…) But when that thought creeps in, it makes my chest feel tight, like it's hard to breathe (Participant 1).
(…) I thought I was getting better, (…) I've been coming to the center since last year, and I'm still here … so it feels like maybe I haven't improved. And honestly, I feel kind of ashamed in front of the other staff, like they must think I'm not making progress (Participant 2).
Subtheme 2: Practical constraints on center utilization
Participants felt comforted by the understanding and support they received at the YMHC, but they continued to lack supportive systems outside of it. They stated that it was difficult to open up with friends or colleagues. They expressed disappointment that their families did not fully grasp their struggles, and found it difficult to express these feelings. They also voiced frustration about practical constraints such as limited participation due to work or school schedules and the challenge of accessing services on weekends. Many wished for more opportunities to connect with others. They hoped that the YMHC would expand its programs to include a broader range of activities, such as community events and cultural programs, beyond just therapeutic services.
Honestly, I don't have anyone to rely on outside the center. The only people who could help are my family, but they're all busy with their own lives, so they can't care for me either. (…) (Participant 7).
I wish there were more programs we could do outside the center. The ones we do inside are great, but I'd like more time for outdoor activities or experiences that are hard to do alone. (…) (Participant 10).
Theme 4: Emerging New Hope
Participants reported that they were no longer afraid of reentering the world. With the support they received at the YMHC, they gained the strength to face their challenges and found renewed hope for recovery, along with the courage to overcome new obstacles. They started to rebuild lives that had once seemed stagnant, gradually gaining confidence and forming positive expectations of themselves.
Subtheme 1: Gaining courage for new challenges
Through their experience at the YMHC, participants reported gaining the courage to face new challenges. They better understood the realistic difficulties caused by their symptoms and mental health conditions while also recognizing their ability to manage and overcome them. Unlike earlier, their fear of failure decreased, and they expressed a growing sense of self-confidence. Empowered by this belief, the participants began taking concrete steps toward their personal goals, such as writing resumes and attending job interviews, which they had previously avoided due to fear or hesitation.
Previously, (…) I felt like everything was my fault and that nothing could be fixed. (…) But now… I feel like if I faced that situation again, I might handle it differently. And if it doesn't work out, I'll try another approach (Participant 3).
I'm thinking about looking for a job again. It used to seem terrifying-I didn't even want to consider it. (…) (Participant 2).
DISCUSSION
This study thoroughly explored the experiences and meanings of young adults with mental health issues who utilized the single YMHC in South Korea. Four themes were derived from their interviews: "Reconnecting with the world and seeking change," "Journey of recovery that began together," "Obstacles still to overcome," and "Emerging new hope."
Participants sought help at the YMHC to reconnect with the world and foster positive change. Most were young adults in their 20s and 30s facing challenges such as school and work adjustment issues, job failures, interpersonal conflicts, and symptoms of depression, anxiety, and psychosis. A considerable number of them were already receiving psychiatric treatment. Their journeys to the YMHC often began through personal searches for help or referrals from family and friends. Research by Park and Lee [15] highlights the crucial role of these social connections in seeking mental health support. Similarly, Kim's study [12] on Mind Link showed a shift over time: while 58% of early referrals came from medical institutions, referrals from family and voluntary visits increased to 51.9%. This reflects the growing demand for mental health services and changing perceptions among young people. Although the participants were already receiving psychiatric treatment, they sought the YMHC for a space to connect with peers facing similar challenges and to foster a sense of belonging. Participants from other mental health welfare centers found it hard to empathize with individuals of different ages with chronic mental illnesses. This underscores the need for youth-friendly mental health programs that consider the stage of illness and life cycle characteristics, as providing the same services to young adults at different stages is ineffective [12]. Participants recognized the need for professional help for their mental health issues, but it took time and caused hesitation before they used YMHC services. Social and self-stigma are significant barriers to accessing mental health services [19]. Young people often fear that mental illness will negatively impact friendships, career choices, and marriage, making it harder to seek treatment and recover [15]. Concerted efforts are essential to empower young individuals to acknowledge their mental health needs and seek assistance without hesitation.
Participants met peers with similar difficulties at the YMHC, where they began their recovery journey. Unlike other institutions that lacked emotional empathy, the YMHC provided a supportive environment for sharing struggles and fostering a sense of belonging. This aligns with research highlighting the importance of peer support in mental health recovery [20,21]. Emotional bonds within these groups are crucial for emotional stability and providing motivation for recovery [21]. Mental health services should systematically promote peer interactions. Group programs focused on building supportive relationships, activating peer networks, and training peer supporters can effectively enhance youth mental health recovery. Participants restored their daily routines by practicing appearance management, maintaining regular living, and keeping appointments. These changes show how social commitments and activities at the YMHC help restore daily life. Participants received counseling and referrals to psychiatrists to enhance their understanding of mental health. Young people are more likely to utilize mental health services if they recognize their issues. Therefore, it is essential to establish a system that provides accurate information on mental health and disorders in young people before they face psychological difficulties [15,22]. Participants emphasized that economic support, such as treatment cost assistance, is essential for young people with mental health issues to start and continue their care. Those in their 20s and 30s were balancing job preparation or academics with economic activities, making treatment expenses an added burden, especially during interruptions in their economic activities. They reported the greatest concern about treatment costs compared to other age groups [23]. Young people's economic vulnerability hinders their use of mental health services. To address these psychological and emotional issues, we must consider social-structural factors, expand universal mental health services, and establish mechanisms to provide stable financial support for mental health services [10]. Providing services for young people with mental health issues requires improved professionalism, accessibility, and financial support, as these factors greatly impact recovery. While participants in the YMHC experienced positive changes, they also faced ongoing feelings of depression, helplessness, and interpersonal difficulties. This led to doubts about their recovery potential and diminished self-efficacy. Many suffered from psychological isolation due to a lack of understanding and support from their families and peers, which created further obstacles. This uncertainty and reduced self-efficacy can impede the recovery process [24, 25]. Interventions are crucial to reduce uncertainty by offering clear information about the illness, prognosis, treatment, and procedures early in recovery. A lack of social support can worsen mental health issues and impede recovery, while rebuilding trust within peer groups is a key factor for young adults' recovery [9,10,26,27]. Effective psychological support should be tailored to individual recovery paces and experiences, alongside the simultaneous training of young adult peer supporters. While participants were generally satisfied with the program, weekday- only hours and limited content diversity hindered its usage. For young adults juggling academics and job hunting, these accessibility issues decreased satisfaction. This supports the evidence that when mental health services fail to reflect users' lifestyles and needs, accessibility and effectiveness are limited [20]. To improve youth mental health services, it is essential to implement programs that enhance autonomy and accessibility and tailor them to the specific needs of users. In addition, a flexible operational system that reflects user independence and lifestyle is crucial.
Building on positive experiences with the YMHC, participants developed "hope for a new life" by exploring new academic pursuits, jobs, hobbies, and other activities. However, psychological pressure from an uncertain future and social expectations persist during the early stages of recovery. This indicates the need for comprehensive support systems that address the practical issues faced by young adults, such as career, financial, and housing concerns [28,29]. It is essential to facilitate the development of small, successful experiences through personalized recovery plans and step-by-step support tailored to each young adult's situation. This strategy aligns with the call for multidisciplinary approaches emphasized in the mental health field and is supported by numerous studies as a key way to improve recovery sustainability [29,30].
The significance of this study to nursing education, research, and practice is outlined as follows. In nursing education, this study provides foundational data for developing curricula that enhance the competencies of psychiatric nurses. Nursing educators can utilize insights into young adults' experiences with mental health services to create evidence-based programs. In nursing research, this study offers a comprehensive exploration of young adults' experiences with mental health problems from their own perspectives. This area has been relatively underexplored in the nursing field, and the study provides in-depth insights that quantitative approaches alone cannot fully capture. Specifically, it highlights young adults' initial motivations for seeking mental health services, the circumstances that prompted them to access care, the benefits they perceived, the challenges they encountered, and their expectations for improved services. This will contribute to the expansion of knowledge in youth mental health nursing. Regarding nursing practice, this study emphasizes the importance of understanding young adults' experiences with mental health services to enhance nursing care. By revealing their motivations for seeking help, the challenges they face, and their expectations for support, the findings provide psychiatric nurses with actionable insights for practice. This knowledge can inform the development of more tailored, age-appropriate, and effective care strategies, facilitating stronger engagement, fostering therapeutic relationships, and ultimately improving outcomes for this population. Additionally, these findings can serve as evidence to support policies aimed at improving mental health literacy through education for young adults and raising social awareness of mental illnesses.
This study has the limitation that it was conducted with users of a single youth mental health center. In this regard, the experiences of young adults may not have been fully captured due to variations in service provision methods, community characteristics, and the accessibility of different YMHCs. Therefore, careful consideration is essential when determining the transferability of this study's findings to other YMHCs or regions in various contexts. Considering that YMHCs may vary in organization and services based on community characteristics, future research needs to include diverse community contexts and program models. Additionally, we suggest that future research classify young adults according to their developmental tasks, taking into account factors such as age, occupation, socioeconomic status, and other variables.
CONCLUSION
This study explored the experiences of young adults with mental health issues who utilized the YMHC. The results revealed that the YMHC connects young adults to the world and serves as a refuge. Peers with similar issues help restore social relationships and motivate reengagement in activities. The YMHC's professionals support young adults in understanding their issues and beginning their recovery journey. This study provides insights into the utilization pathways, benefits, limitations, and recovery journeys of young adults using the YMHC, forming a basis for developing targeted mental health programs for the community.
PDF Links
PubReader
ePub Link
XML Download
Full text via DOI
Download Citation
