By Nia West-Bey and Marlén Mendoza

Behind the Asterisk*: Perspectives on Young Adult Mental Health from “Small and Hard-to-Reach” Communities describes findings from focus groups in “small and hard-to-reach” white rural; Asian American, Native Hawaiian, and Pacific Islander (AANHPI); and urban Native American communities, along with a diverse group of young adults experiencing homelessness. These communities are often relegated to an “asterisk” in research and excluded from national policy discourse because their numbers are too small to be considered reliable or are hard to reach using typical research methods. Our report brings these often-overlooked young people whose experiences are largely left out of policy discussions to the forefront. 

The report includes five main sections: 

1. Go throughs, too: Threats to mental health and perspectives on effective and ineffective supports that align with findings from our earlier work. 
2. Unique perspectives: Additional threats to mental health and valued supports uniquely identified by small and hard-to-reach communities. 
3. The role of health insurance: Young adults’ understanding of health insurance and its interaction with mental health care. 
4. The meaning of mental health: Young people’s understanding of mental health and the implications of that meaning. 
5. Policy implications and recommendations: Opportunities to achieve positive, inclusive, and equitable change. 

Behind the Asterisk* concludes with 10 high-impact policy recommendations for systems reform and mental health equity.