Transitional age youth (alternatively: TAY, Transition Aged Youth, Transition-Age Youth, Transitional Age Youth, Transitioning Youth, Transitional Youth, and Youth in Transition) can reference both a developmental period and be a descriptor regarding eligibility for certain services. While there are variations in definitions, the age ranges do consistently overlap and include late adolescence (15–16 years of age) to early adulthood (24–26 years). This range is considered a critical period in human development characterized by several changes socially, environmentally, and cognitively. During this time, individuals can experience changes in their social roles and function, family and peer supports, exposure to substance use, educational and vocational programs, as well as changes in healthcare providers from pediatric to adult settings.
History The phrase transitional aged youth (TAY and the variations listed above) originated in the foster care system but has since taken on broad applicability to other (primarily healthcare) sectors. Specifically, youth “in transition” can refer to “aging out” or being ineligible for pediatric health care services after turning 18 years old, or being ineligible for children's mental health services at 18 years old in certain places. The adult outcomes for youth involved in various child-serving systems (special education, pediatric primary care, child and adolescent mental health, child welfare, and juvenile justice) came under scrutiny in the 1980s. As a result, planning around the transition from child to adult services became a focus across many systems. In mental health systems, the term transitional aged youth (TAY) has historically been associated with youth and young adults at high risk of poor transition outcomes due to complex needs, lack of a support system, and multiple challenges. Earlier studies on young adult outcomes used the term to describe individuals from 16 to 25 years old who have, or are at risk of having, Serious Mental Illness (SMI) or Serious Emotional Disturbance (SED), defined as serious emotional or behavioral difficulties that are psychological in origin, in combination with significant functional impairment, and arise by age 18 years. Terminology has since evolved, both in mental health and in federal initiatives. For example, the Substance Abuse and Mental Health Services Administration (SAMHSA) has broadened its scope to include TAY with SED and in the general public, through its Now Is The Time Healthy Transitions program. This expansion likely reflects the growing knowledge that all youth of transition age are at risk for mental health issues, substance abuse disorders, and suicide. Therefore, TAY is being used more often to refer to all individuals within an age range, regardless of presence of SED or service system involvement. Other terms which overlap with TAY include Emerging Adulthood (EA), coined by Arnett who proposes EA as a normal discrete developmental phase for all persons 18–25; Adolescents and Young Adults (AYAs), historically those with cancer but now more generally referring to all health needs of 10-25 year-olds; and Youth and Young Adults (YAYAs). Sometimes, the acquisition of tasks during this developmental phase has been colloquially termed, “adulting”.
Developmental tasks Like many other developmental stages, the period of transition from adolescence to early adulthood is faced with many unique challenges. TAY must consolidate and build upon the tasks that they started in adolescence, including the enrichment of their identity, independence, and relationships. During this period, their bodies begin to reach physical and sexual maturity, while cognitive and psychological development often trail behind. Physically, TAY undergo puberty mediated by sex hormones, including increases in testosterone and estrogen, and begin to develop secondary sex and traditional gender role characteristics. Cognitively, they start to form a moral code, combining aspects of societal expectations and rights as well as universal ethical principles. As they work towards independence, TAY must acquire skills for adulthood, such as learning how to manage finances, housing, and medical and legal decision-making, in order to move away from reliance upon family for basic needs. Smaller steps needed to gain success include learning how to create and maintain a budget, identifying “needs versus wants,” and opening a bank account. Legally, many youth will continue to require their guardian's consent/permission for many medical procedures, medications (including psychiatric), and services until they reach the age of majority. Independence also involves forming and maintaining fulfilling relationships outside of the family unit. As dependence on the family lessens, relationships shift to companionship, support, and intimacy with peers. Friendships become more important as TAY further individualize and psychologically discover who they are. Intimate relationships are often more challenging to develop, and many may not find a partner during this developmental period, as TAY navigate the stresses of biological and hormonal drives, psychological wants for intimacy and acceptance, and weigh potential negatives including parental disapproval, possible pregnancy, sexually transmitted diseases, and peer rejection.
Population health In 2020, the global population of 15-24 year olds was estimated to be 1.2 billion, accounting for about 15% of the world's total population. The health of adolescents is a critical component of a successful transition to adulthood. This period is marked by significant physical, cognitive, and psychosocial growth, and is an important time for building foundations for good health. While young people are typically seen as healthy, this period can correlate with a rise in health problems, including the emergence of mental health issues. In the last decade, depression, anxiety, and injuries (road injuries, self-harm, and interpersonal violence) were among the top ten causes of death in 10-24 year olds.
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