Klodnick, V. V., Sabrella, K., Brenner, C. J., Krzos, I. M., Ellison, M. L., Kaiser, S. M., Davis, M. & Fagan, M. A. (2015). Perspectives of young emerging adults with serious mental health conditions on vocational peer mentors. Journal of Emotional and Behavioral Disorders, 23(4), 226-237. Doi: http://dx.doi.org/10.1177/1063426614565052
Summarized by Jessica Cunningham
Emerging adults with serious mental health problems such as bipolar disorder or schizophrenia are at increased risk for poor higher education and vocational outcomes. Young adults who were diagnosed with these problems in their youth are also more likely to have multiple mental health diagnoses, have been involved with the foster care system or residential treatment programs.
All of these things put them at higher risk for low educational attainment and low rates of employment, because residential treatment can separate them from their families, peers, and high school. Emerging adults are experiencing multiple transitions; going from high school to college or employment, and becoming independent from parents or the foster care system, which can be incredibly stressful without the added stress of having to navigate these transitions with mental illness(es).
Previous research on close-age peer mentoring in other populations has come up with mixed results; in samples of college students, mentoring was associated with higher college satisfaction but not GPA or graduation rates, so the benefits of peer mentoring may not translate to easily tangible or “concrete” outcomes, but may be valuable in other ways. The researchers of this study wanted to test the feasibility of close-age vocational peer mentors for emerging adults with serious mental health problems.
The researchers developed this program as a part of Thresholds, a mental health program in Chicago. This program served as an adaptation of the organization’s Individual Placement and Support program, which places people with severe mental illness in supportive employment. Thresholds serves people from 16-22 with one psychiatric diagnosis along with people who have one or more comorbid disorders.
Thirteen peer mentors were hired by the agency, and they ranged in age from 20-30, with the majority being between 22-24 years old. Nine participants identified as African-American, three identified as Latino, and one participant identified as White. All but one mentor had a serious mental health condition. In order to qualify to be a peer mentor, participants had to hold a high school diploma/GED certificate who has held a job for at least six months and/or be enrolled in a higher education institution; and preference was given to those with a serious mental health condition who were also graduates of Thresholds’ young adult program.
Mentors attended a 40 hour training and were assigned one to six mentees with whom they were to meet once per week for half an hour to an hour. Mentors were told to try to focus a quarter to half of their meeting time on helping mentees develop professional skills, exploring educational and career options, and how to develop positive relationships with coworkers and peers in education or employment environments. Mentors also worked in conjunction with vocational specialists and clinical social workers in order to facilitate the best outcomes for their mentees.
Mentees were people in the young adult program with at least one year left in the program, and who were not currently employed or enrolled in school but were interested in doing so. Of the 44 people eligible to participate in the program, 35 enrolled. Thirty three mentees met with a peer mentor at least once; and 21 participants completed survey measures; among them, thirteen identified as female, and eight identified as male. Ages of mentees ranged from 19-20, with a median age of 18. Some mentees were lost to follow up as they had discharged from the program and were unable to be contacted, others were incarcerated, and one declined to participate in the survey portion of the study. Thirteen participants had a mood disorder as their Axis I diagnosis, seven had a psychotic disorder, and one participant had a developmental disorder. Seventeen participants had an additional disorder, post-traumatic stress disorder being the most common; ten participants had this diagnosis.
In order to elucidate the experiences of the mentees within the program, the researchers developed a mostly open-ended satisfaction survey that was distributed at the end of the program. The survey included questions such as “what did you like most and least about your peer mentor?; what was helpful and not helpful about meeting with your peer mentor?; how do you think you benefited from this program overall?; over time, was your mentor able to help you develop and/or achieve your vocational goals?” along with questions asking the degree to which participants agreed or disagreed with the idea that peer mentors should have school/work experience, be the same age or gender as the mentee, have a serious mental health condition, and self-disclose personal experiences.
The researchers also asked mentees to complete the Working Alliance Inventory-Short Form which is a 12 item self-report measure of the working alliance between a mental health care provider and their client; scored on a 7 point Likert scale from never to always. The items were altered to replace “therapist” with “peer mentor”
Mentees met with peer mentors anywhere from 1 to 30 meetings; 9 was the median number of meetings between mentors and mentees. Seventy six percent of participants reported benefiting from the peer mentoring program in terms of increased self-awareness and responsibility, job search and interview support, and assistance in connecting with the vocational team. Forty eight percent of participants reported that peer mentoring helped them to develop and achieve their vocational goals. In the open-ended responses, participants reported that peer mentors were able to provide advice and “concrete suggestions regarding vocational goals, as well as helping participants gain insight into the job search process while thinking about the future.” Participants also reported that peer mentors helped them navigate interpersonal relationships and showed them how to find resources in their communities.
In terms of attributes that mentees valued in a peer mentor, being “positive”, “trustworthy”; being able to empathize because of shared experiences, and someone who has had experience in overcoming personal obstacles. Mentees valued mentors who did not “look at them differently” or “put on a phony act”, and felt that mentors sharing their experiences was helpful in navigating their own personal struggles. Being understood by mentors and also understanding them also appeared to be important to mentees. Mentees reported feeling “safe and listened to” with mentors, and felt that having an opportunity to get away from the complex was helpful.
Seventy six percent of mentees agreed or agreed strongly that mentors should have work or school experience, 67% felt that it was important for a mentor to be a graduate of YAP, but being similar in age, gender or mental health status was seen as less important. Forty eight percent of mentees felt that self-disclosure was important; 38% did not agree that it was important, and 19% felt it was not important or unimportant.
The median score for the 21 participants who completed the WAI-S was 65.00; and ranged from 24 to 84. Participants who reported primarily positive peer mentoring experiences had higher working alliance scores.
Conclusion & Discussion:
This exploratory study showed the viability of an employment and education-based peer mentoring program for young adults with severe mental health problems. Some youth in this study appreciated having mentors similar to them in age but had heightened appreciation for mentors “who possessed similar life experiences and for the development of a special bond based on trust and understanding.” Some mentees did not find their mentors particularly helpful, and this may be because they had already formed strong bonds with their vocational specialist or other people in their social network who could help them navigate education and career exploration and goal-forming. In order to develop best practices for peer mentoring programs for young adults with severe mental health conditions, more research with larger sample sizes and a more diverse pool of participants is required. However, this study does take an important first step in that direction, and this field shows promise of “filling a developmental void in support” for these young adults.
To read the abstract of the original research article, click here.