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Advantages of Urban Mental Health Treatment for Young Adults

The Benefit of Urban Mental Health Treatment for Young Adults

Est. reading time: 12 mins
Posted Under: For Families, Treatment Insights

Clinically Reviewed by: Amanda Fialk, PhD, LCSW, LICSW


Living in a bustling city represents a powerful draw and significant milestone for many young adults—an opportunity for academic and career exploration, community engagement, and personal growth.  However, for those seeking intensive mental health support, navigating urban treatment and life can seem daunting, especially for individuals venturing into independent living for the first time.

At The Dorm, we have over 15 years of success helping young adults navigate mental health issues and learn to thrive in our country’s most celebrated urban hubs. Our clients at The Dorm report 138% improvement in well-being as a result of our care, (including the ability to work and find contentment in daily living). This does not happen by chance. In this article, our clinicians, leadership team, and trusted colleagues will provide insights into how our model of treatment is so effectively preparing young adults to design a fulfilling life beyond their therapeutic journey in the cities where they choose to work, live and study.

Key Benefits of Urban Mental Health Treatment: 

Build a Life In Tandem with Mental Health Support: Instead of pressing pause or relocating to get support, urban-based treatment allows young adults to stay connected to their community and continue the pursuit of long-term goals alongside the structure, accountability and clinical care they need.

Educational and Vocational Opportunities: Cities host a multitude of universities and vocational pathways, allowing young adults to pursue academic and career goals alongside and beyond treatment.

Skill Practice and Trigger Management: Cities provide diverse settings for practicing coping skills and managing triggers, crucial for sustained recovery and reduced relapse rates.

Access to Supportive Communities: Urban areas offer dynamic, sober and substance-free communities that foster connection and mutual support.

Life Uninterrupted: Continue to Pursue Goals In Tandem with Mental Health Support

It’s a common myth that someone must always be removed from people, places, and things to be successful in treatment. Instead, research indicates that when a person can receive support while integrated into their community of choice it improves the likelihood of long-term recovery outcomes. 

Our model embodies this idea by locating in the urban centers in which so many young people are seeking to establish themselves, and offering clinical support that ‘runs alongside them’ as they continue to pursue long-term goals like higher education or a career. Instead of the pauses and relocations often associated with comprehensive treatment, our care is designed to enable individuals to grow and “thrive-in-place”. By the time a young adult is done with treatment with us, for example, they have:

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  • Fully integrated into city life and will be committed to full-time daily pursuits (i.e. school/work/volunteering) with a consistent schedule and routine
  • Are living independently in their own apartment/with roommates or in a dormitory
  • Enjoying engaged friendships and community networks

All that’s left is to continue moving forward with building the independent life they have established with us in treatment. Today, 87% of our client alumni are in school full-time or gainfully employed. Skip ahead to learn more about how our model of treatment supports this process.

Urban Environments are Catalysts for Academic & Vocational Growth

Access to some of the world’s top universities and higher education institutions is a significant advantage of exploring young adulthood in the big city. In the United States today, 68% percent of colleges and universities are located in cities, serving over 20 million students. There is no question that major cities offer unparalleled access to exciting and engaging places to study and launch into a career.

For students who also need the support of intensive mental health treatment, an urban environment provides the chance to engage in academics alongside treatment and the scaffolding of ongoing professional support. At The Dorm, our University & College Support services offer individualized care to help students succeed academically while managing their mental health. Depending on the client’s individual needs, this support may include:

  • Comprehensive academic assessment
  • Neuropsychological testing
  • Clinical coaching to locate and pursue long-term care accommodations
  • Subject-matter tutoring 

Additionally, as experts in young adults care, our clinicians are trained to provide intensive interventions for issues that may be hindering our students’ goals, such as anxiety and related school refusal, while at the same time teaching the skill-building necessary to improve executive functioning and college readiness. Today, 67% of our clients return to their original program of study and 83% of our clients return to school after they take a leave of absence for treatment.

Pursuing treatment and other goals simultaneously

For clients already on the university path, ongoing access to a program that they’re enrolled in can be incredibly beneficial to maintaining structure during mental health treatment.

Martha Cedarholm, Director of Student Advocacy at Pratt Institute, has spent decades working as an advocate for students struggling with mental health, and is well versed in the common questions of “Should I take a leave of absence for mental health treatment?

“In the earlier days of my career, I always thought it was best for a student to go away from treatment…mostly out of fear that college psychological services wouldn’t be able to adequately support them,” says Cedarholm. “But as I’ve gained experience, I saw the real benefits of seeking treatment while continuing with a reduced course load. Having structure to daily life is so important for young people – college life can offer all this scaffolding to support them alongside treatment communities like The Dorm.”

Martha Cedarholm, Director of Student Advocacy at Pratt Institute

In other words, college life provides structure and routine that young adults so often need during periods of mental health crisis. Resident advisors, fitness and gym facilities, learning access centers, and predictable class routines are just a few examples that help support stability during and after mental health treatment. 

Opportunities to Explore Career & Vocation

Alternatively, for our clients who have completed or decided to forgo university, and are equipped with the skills they need to navigate the early steps of a career, treatment within an urban setting is an opportune time to practice career skills that are often not taught in school or at home. The Dorm’s Job Readiness & Career Support program helps clients develop career skills and explore their innate passions. 

During treatment, The Dorm Career Support programming help provide individualized support & skill-building for:

  • Exploringing vocational interests
  • Building a resume
  • Preparing for interviews
  • Role playing common job-seeking scenarios

We teach young adults the social skills, problem solving skills, and executive functioning skills that they’ll use into adulthood when it comes to locating jobs that will satisfy their interests and life goals,” notes Assistant Director Alexa Connors, LCSW. “It’s not that we ‘get a job’ for our clients, we help them build the skills they will use to navigate careers for the rest of their lives.”

The Chance for Personal Exploration

Young adults are often not sure what the future holds for them. For many of our clients, thinking of intensive treatment as a therapeutic gap year gives them the freedom and enthusiasm to fully commit to the holistic mental health treatment that will give them the stability and confidence to explore their innate interests and take action on them.

Typically, students will take a semester abroad, but for those struggling with mental health, going abroad really isn’t an option for them,” says Tere Snodgrass, Director of Admissions & Referral Experience. “So, being able to spend some time in New York or DC allows them to have that experience of living in a new city and going beyond their comfort zone that others may be getting—experiencing someplace they have never been, developing their areas of interests, exploring academic programs – but with wrap-around support from mental health professionals every step of the way.

Strong Activism and Volunteering Networks

Beyond educational and vocational opportunities, an urban environment provides an abundance of opportunities for volunteering and activism. Mental health professionals have long known the benefits of volunteering for young adults in treatment, including enhanced social connections, career prospects, and improved self esteem. (This is why Service is a core pillar of care at The Dorm “Be good, do good, and feel good by giving yourself in service to others.”) 

Volunteer and activism groups offer clients a unique view into how a society functions and the role they can play in improving the quality of life in their communities. For example, at The Dorm NYC, Senior Clinical Community Manager, Valerie Donaldson, leads a monthly service trip at The Dorm NYC, during which clients share a meal with local elders, offering companionship and entertainment.

 “The immediate satisfaction our clients get from looking beyond themselves and improving someone else’s life – right in our neighborhood – is an amazing thing to witness. It gives our clients a huge sense of empowerment and self-efficacy,” says Donaldson. “The importance of volunteering does something neurologically – it helps their confidence.”

In a city environment, clients not only have the chance to give back but there are countless organizations and industries that actively seek their help. This intersection of interest and opportunity illustrates another example of how the connections clients can make during treatment may provide long-term community and personal fulfillment.

Skill development and managing triggers in real-time

Pursuing treatment in an urban environment allows young adults to practice new therapeutic skills while they gradually integrate with their new environment with clinical support. It is one thing to learn and practice skills within a wilderness setting or other safe therapeutic treatment milieu. It is another thing to translate those skills into unexpected situations and events after treatment.

In an urban environment, this process may seem at first impossible for young adults who are struggling with co-occurring disorders such as social anxiety, substance use disorders, eating disorders, or learning differences — big cities have bars on every corner, countless overwhelming sounds, sights, and smells, and complex social systems to navigate on a daily basis.

But, when a client has chosen to enter a treatment community in these environments, they aren’t alone – they are bolstered by a team and community of like-minded peers, and compassionate health & wellness practitioners who are experts in guiding them through the steps of learning to manage triggers in any situation that comes their way.

“For clients who want to pursue a life, career, family, and community within an urban environment, it’s essential that they practice treatment skills in this setting to gain competency, confidence, and a sense of self efficacy before being able to give back to their greater community.”

John McGeehan, LCSW, CEO & Founder

What does a clinical coach do?

At The Dorm, clients in our higher levels of care benefit from treatment from both a primary therapist and clinical coach, who remain in weekly contact with their family members, health and wellness team, and any supplemental providers. 

The goal of a clinical coach is to walk hand-in-hand with the client as they navigate everyday scenarios, such as exploring public transportation, maintaining an apartment, paying bills, forming productive relationships, managing money, and locating help when necessary – all tasks that can easily set a young adult back during early sobriety and mental health recovery if they are not practicing these skills in the situations that they’ll be exposed to after treatment.

As clients have had several sessions (ranging from weeks to months) with a clinical coach to practice skills in a variety of settings, The Dorm model is designed to gradually remove the therapeutic scaffolding as clients are better equipped to not just exist but thrive in the city they call home. As a result of treatment with us, our clients experience 24% improvement in personal self-efficacy: the confidence in one’s ability to accomplish goals and problem-solve.

Personal Development and Community Integration

Embarking on treatment in an urban setting also offers young adults an important advantage: the chance to maintain continuity within the familiar environment that supports sustained recovery after treatment.

This approach minimizes disruptions and the stress associated with moving to a new place, fostering a sense of stability and security. By maintaining established routines and connections, clients are better positioned to sustain the progress made during treatment, ultimately leading to more successful and enduring outcomes.

“Community integration is an important part of sustained mental health, and when we see that clients have built a sober network, supportive friends, and they are getting affirmation through long-term groups, this is a sign they will be able to maintain their new skills outside of treatment”

Britt Melewski, LCSW, Director of The Dorm NYC.

Substance-Free Communities & 12-Step Programs

To elaborate on this idea, consider the significant achievement of building a sober community. This usually comes after committing to consistent group meetings, finding a sponsor, mentoring newly sober peers, and slowly discovering the joy and fulfillment that comes from discovering life beyond substance use.

If you’ve been doing a lot of community-building in treatment, and then suddenly move to a city to start or return to school, it can be overwhelming and unfortunately increase the chance of relapse,” explains Amanda Fialk, PhD, LCSW, LICSW. 

Transitions, even when they are positive and exciting, can be challenging. It’s human nature to struggle with new environments, which is part of the problem when young adults are jolted from a treatment setting to the ‘real world.’

Dr. Fialk goes on to explain that change is inherently difficult and can be uncomfortable, like the unease one might feel when switching the wrist on which they wear their watch. Creating a treatment experience in an urban setting, where clients can progress through the continuum of care helps to mitigate the risks of unnecessary recidivism often associated with geographic transitions.

Further, large cities have the greatest population of sober communities that clients coming from other treatment milieus might not have the support to discover. For example, one group that The Dorm clients have benefited from is the long-standing “Not a Glum Lot” AA Group in New York City. Since 1999, this thriving community has met on a weekly basis in Manhattan and plans seasonal field trips to nearby rivers, beaches, and nature trails.

“Recovery can and should be fun! Young people’s sober networks in major cities like NYC are thriving. At any hour of any day you can find young people’s meetings where you can connect with like minded peers. Young people are not going to maintain sobriety or a life congruent with mental wellness unless they develop a network of peers with whom they can experience laughter, connection and joy.”

Dr. Amanda Fialk, PhD, LCSW, LICSW, Partner and Chief Clinical Officer
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Diverse & Inclusive Communities

Apart from sober communities, for those struggling with racial trauma or identity, city life also offers a rich history of social diversity, crucial for effective mental health treatment. 

One such example is Pride Month festivities in New York City and Washington, D.C. – experiences that have shaped treatment at The Dorm since its foundation and tied our communities in closely with our diverse and dynamic neighborhoods.

“Being in Dupont Circle makes a huge difference for our clients exploring identity. Historically this area has been a region with a large LGBTQ+ population; the businesses have been affirming for a long time; the crosswalks are even painted rainbow. I remember my first Pride month in D.C. and being blown away at how many were out celebrating on Dupont Circle. Being in cities that lend themselves to a diverse population can be helpful for clients.”

Amie DiTomasso, LCSW, Assistant Director of The Dorm D.C.

A part of mental health treatment is about discovering excitement, intrigue and opportunity around you. With locations in New York City and Washington, D.C., we’re grateful to have the advantage of being surrounded by a rich history of social diversity that welcomes clients from all walks of life – helping clients pave the way for long-term relationships and community connections. 

The Role of Therapeutic Scaffolding – Facilitating a Seamless, Invisible Transition into Life Beyond Treatment

Analogous to scaffolding around a building under construction, our therapeutic approach at The Dorm provides essential support as young adults navigate urban life. This “scaffolding” gradually diminishes as clients gain confidence and independence, ensuring a sustained and almost invisible, seamless transition into the broader community. When they leave treatment, their community, career, and routine have become the new support system that they’ve learned to navigate with the support of a trusted clinical team and therapeutic community.

Of course, every client’s support system will look slightly different depending on their goals, but what is consistent is that the scaffolding we place around each client includes ongoing skill-building within a supportive, long-term community that continues into alumni programming and peer mentorship. 

In conclusion, the goal of treatment is always to launch young adults into a sustainable long-term recovery that feels meaningful and rewarding for their unique goals and skill set. For countless young adults, their goals are closely intertwined with relationships, educational institutions, and career paths that are increasingly rooted in large urban settings. For clients who have moved through a treatment journey in the city in which they’re excited to put down roots, they have mastered the executive functioning, social, and emotional skills that they will need to thrive in the place that they want to launch into adulthood.

Today, 87% of alumni at The Dorm are in school or employed, pursuing their dreams, and thriving. We believe a part of this success rate is deeply intertwined with our beloved home cities and all of the rich opportunities they provide, including access to a diversity of higher education and vocational opportunities, a unique playground in which to build passions and explore, and the enormous benefit of not having to choose between treatment and pursuing other life goals.


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