We identified articles with googlescholar.com, PubMed, and PsycINFO using the search terms “mental health”, and “emerging adulthood”, or “young adulthood”, or “transition to adulthood”. We drew mainly on the authors' combined decades of experience in this area. The reviewers drew our attention to additional articles.
SeriesThe new life stage of emerging adulthood at ages 18–29 years: implications for mental health
Introduction
What does it mean to become an adult, and what marks the transition to adulthood? All cultures have an answer of some kind to this question.1 Furthermore, the answers change over time, as cultures change. Since 1960 in high-income countries, conceptions of the transition to adulthood have shifted from a focus on events such as leaving home to the gradual attainment of psychological markers such as accepting responsibility for one's self and making independent decisions.1, 2, 3
One unmistakable cultural change in the past half century is that the transition to adulthood has become longer, and in developed countries happens later in life than previously, as measured by the timing of traditional markers such as the entry to stable work, marriage, and parenthood.4 In fact, the period between the end of adolescence (around age 18 years) and the entry to a stable adulthood is so long today in high-income countries that it constitutes not just a brief transition to adulthood but a new life stage between that of adolescence and of young adulthood—emerging adulthood—lasting from age 18 years to about age 29 years.5
In high-income countries today, the period from 18 years to 29 years of age is more usefully understood as a life stage of emerging adulthood than as the tail-end of a so-called extended adolescence, or as the early part of a so-called young adulthood that stretches from 18 years to 40 or 45 years of age.1, 5, 6, 7 Although development during the ages of 18–29 years shares many similarities with that of the preceding or following stages, some important features make this period of emerging adulthood distinctive. Unlike adolescents, emerging adults are not going through puberty, are not in secondary school, and are not minors under the law. They have reached physical and sexual maturity, and are highly diverse in their educational and occupational combinations and trajectories. Some are in full-time work, others in tertiary education full-time, and many are combining work and education, especially in their late teens and early twenties. By contrast with young adults in their thirties, most emerging adults have not yet set up the stable structure of an adult life, with long-term commitments in love relationships and work. Conversely, emerging adulthood is a period of heightened instability, since young people experience a series of love relationships and frequent job changes before making enduring decisions.
Distinguishing emerging adulthood from extended adolescence or young adulthood might be a useful heuristic approach for clinicians and mental health service providers. To treat these individuals as adolescents underestimates their capacities for self-direction, self-reflection, and independent living.5 Likewise, it is essential to recognise that because these individuals are emerging adults, not adolescents, they can refuse mental health treatment (because they are no longer minors under the law), in nearly all countries. In the USA, people in the emerging-adult age range disengage from mental health treatment at higher rates than do younger or older people, perhaps because they have reached an age at which they no longer have to accept treatment initiated by their parents.8 By contrast, health-care workers who see them as young adults might not recognise how much of the instability and uncertainty they experience is normal to the life stage of emerging adulthood and potentially healthy rather than a symptom of a serious mental health disorder.
Given the prevalence of mental health disorders at age 18–29 years, a distinctive developmental concept of this period is imperative. Although the age of onset of many mental health disorders is most often in adolescence, according to a review9 of epidemiological studies in the USA, the 12-month prevalence of any psychiatric disorder is more than 40% in people aged 18–29 years, higher than in people in any other age range, especially for anxiety disorders, mood disorders, and substance misuse. Similarly, in Japan, results from a national epidemiological survey10 showed anxiety disorders and mood disorders were the most prevalent psychiatric disorders in people aged 20–34 years and in the previous year the incidence of these disorders was higher than in adults aged 35 years or older. An understanding of emerging adulthood as a normal developmental period with distinctive features in the life course of people in high-income countries has the potential to enhance the effectiveness of mental health approaches.11
In this review we begin with an overview of the demographics of late entry into adult roles in high-income countries compared with that in low-income countries. We examine some of the notable features of emerging adulthood in the USA, Europe, and Japan. This analysis includes the implications for mental health issues in each region. Although the delayed transition to an adult role is taking place worldwide, our focus in this review is on high-income countries, partly because of the space limitations and partly because research on emerging adulthood has been mainly in developed countries.4
Section snippets
Demographic transitions: ever later
A half century ago the transition to adulthood was brief.1, 2 Most people began full-time work in their late teens, immediately after secondary school (if they even finished secondary school). Few people obtained a tertiary education. Marriage typically took place in a person's early twenties, and parenthood about a year afterwards.
Economic changes in recent decades in high-income countries have resulted in a shift from an economy based on manufacturing to one based mainly on services (such as
USA: five features of emerging adulthood
The USA was the context for the origin of the theory of emerging adulthood, which was based on 300 interviews with people aged 18–29 years in various parts of the country.5, 6 Arnett5, 6 proposed five features as distinct (although not unique) to emerging adulthood: identity explorations, instability, self-focus, feeling in-between, and possibilities or optimism.
Europe: struggle amidst prosperity
Currently, Europe is one of the most affluent and healthy societies in human history.25 In the Human Development Index26 compiled yearly by the UN, which rates countries worldwide on a combined measure of health, education, and wealth, countries in Europe dominate the list with six in the top ten, and 11 in the top 20. However, emerging adults in most countries in Europe face serious barriers to entering the workforce. Although true for many years, the difficulties have increased in the
Japan: movement towards individualism
Similar to other high-income countries, Japan has had demographic changes in the latter half of the 20th century and first decades of the 21st century that suggest the rise of a new life stage of emerging adulthood, especially with respect to the length of education, and the timing of marriage and parenthood. The rate of entry into university was 56% of 18 year old men and 46% of 18 year old women in 2011, compared with 14% of men and 3% of women in 1960.36 Also, the mean age of a woman's first
Conclusions
As this review shows, the way people experience the ages 18–29 years has changed greatly compared with 50 years ago. Rather than a time when a stable adult life is established, this period has become one of extraordinary instability, in love relationships, work, and habitation. Rather than a time of deepening commitments to adult roles, during these years, the entry into marriage, parenthood, and stable employment has been postponed for most young people, sometimes through their own desire to
Search strategy and selection criteria
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