Closing the Rural Mental Health Gap: New Findings Support Training Mentors as Prevention Providers

Gunlicks-Stoessel, M., Weiler, L. M., Choy-Brown, M., Rydberg, K., Beckley, T., He, Y., Hanson, A., & Davis, M. (2026). Addressing rural youth mental health disparities by task-shifting an evidence-based depression prevention program to mentors. Evidence-Based Practice in Child and Adolescent Mental Health. Advance online publication. https://doi.org/10.1080/23794925.2026.2673937

Introduction

Rural adolescents face a higher risk of depression, anxiety, and suicide alongside severely limited access to mental health care. Over two-thirds of federally designated Mental Health Professional Shortage Areas fall in rural regions, and stigma, poverty, and privacy concerns worsen this gap. Gunlicks-Stoessel and colleagues (2026) explored whether community youth mentors could be trained to deliver an evidence-based depression prevention program, Interpersonal Psychotherapy– Adolescent Skills Training (IPT-AST), to middle schoolers in an rural community lacking mental health resources.

Methods

Following the SAMHSA (Substance Abuse and Mental Health Service Administration) adaptation framework, the research team partnered with a rural mentoring organization and conducted interviews and focus groups with youth, parents, mentors, mentor supervisors, and school staff to identify community needs and refine the program. The adapted program, renamed “Rising Together,” was delivered in an open pilot trial to 13 sixth and seventh graders across three groups. Mentors received a 6–8-hour virtual training and weekly supervision from an IPT-AST expert.

Results

The pilot demonstrated strong feasibility and acceptability across all stakeholder groups. Mentors surpassed the 70% adherence fidelity benchmark (81.7%) and came close on quality (68.8% vs. 70% benchmark). Youth and parent reports showed medium-to-large effect sizes for reductions in depression, anxiety, and loneliness, and improvements in peer relationships and social skills. Changes in loneliness were statistically significant.

Discussion

Findings demonstrate that mentors without formal mental health training can deliver a manualized evidence-based program adherently when supported by structured training and ongoing supervision. Fidelity quality scores slightly below benchmark point to the value of role-play-based and just-in-time training approaches.

Implications for Mentoring Programs

This study indicates that existing mentoring infrastructures, such as volunteer networks, can serve as a delivery platform for evidence-based mental health prevention. Training and supervision, however, are necessary components for program success.

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