Paraprofessional Youth Mentoring: New framework proposes the integration of youth mentoring and mental health services

McQuillin, S. D., Hagler, M. A., Werntz, A., & Rhodes, J. E. (2021). Paraprofessional Youth Mentoring: A Framework for Integrating Youth Mentoring with Helping Institutions and Professions. American Journal of Community Psychology.

Summarized by Ariel Ervin

Notes of Interest: 

  • Although a lot of progress has been made to lower the levels of youth mental health and behavioral issues, it’s still prevalent, especially for marginalized youths. 
  • Because many professionals are overwhelmed in meeting the demands of youth mental health services, mentoring can help alleviate the burden. 
  • This paper introduces a mentoring framework where mentors get trained to participate in therapeutic activities with their mentees under professional supervision.
  • It proposes that paraprofessional mentors can 1) lower barriers to seeking mental health services, 2) promote engagement with mental health services, & 3) provide direct interventions. 
  • Competency-based training and evaluations, professional supervision, and documentation of provided services are required if mentoring programs want to shift tasks. 
  • The transition from traditional to paraprofessional models will also require mentoring programs to change their existing structure, culture, and practices.
  • It’s important to keep in mind that mentoring programs can’t close the mental health gap by themselves.

Introduction (Reprinted from the Abstract) 

The demand for child mental health services, including those provided by psychologists, counselors, and social workers, exceeds the supply. This trend is expected to continue or worsen unless there are substantial structural changes in how mental health services are provided. We propose a framework for paraprofessional youth mentors, defined as a subgroup of professionally supervised, non-expert volunteer or paid mentors to whom aspects of professional helping tasks are delegated. Our proposal is aligned with historical and modern solutions to scaling mental health services, and this framework could simultaneously increase the number of youth receiving evidence-based mental health services and reduce the burden on existing systems of care. The framework defines three plausible tasks for paraprofessional mentors: (1) reducing barriers to mental health service, (2) increasing engagement in services, and (3) providing direct services. The safety and effectiveness of these task-shifting efforts will hinge on competency-based training and evaluation, supervision by professionals, and documentation of services rendered, all of which the field of youth mentoring currently lacks. We describe several requisite scientific, institutional, and regulatory advances that will be necessary to realize this variant of youth mentoring for a subgroup of youth who are presenting for assistance with mental health problems.

Implications (Reprinted from Conclusions)

Mentoring programs are well positioned to help bridge gaps in service for youth facing mental health challenges. To achieve this, mentors can be leveraged to serve as paraprofessionals and can task-shift to support or even deliver evidence-based care. It is important to note that, even with this shift, mentoring programs can only do so much to bridge the enormous service gap in our mental health system. Only about 5% of U.S. children and adolescents are served by mentoring programs (Putnam, 2015; Raposa et al., 2017). Moreover, it would also be naïve to assume that developing evidence-based standards, curricula, and documentation structures would be sufficient to translate the effects of psychological intervention research studies to routine organizational practice with paraprofessional mentors (Wandersman et al., 2016). It is unlikely that organizations and institutions will realize these benefits in practice without substantial changes in the capacity and motivation to support the roles of paraprofessional mentors. Indeed, shifting from more traditional relational models of mentoring to paraprofessional models will require substantial shifts in the organizational culture, incentives, expectations, and resources. In many circumstances, this shift might involve adding structures, curricula, or new roles, yet in other cases this may involve letting go of existing guiding theories, expectations, or practices that have characterized mentoring for decades.

There will be other challenges as mentoring programs take on new service models. First, more specialized care may entail additional costs such as licensing fees for validated assessment tools, evidence-based curricula, evidence-based mental health apps, etc. Although programs often balk at such expenditures and opt instead to rely on homegrown tools and trainings, it will be important to consider the opportunity costs, and the better return on investment of more effective models. Additionally, embedding mentors in schools, mental health settings, and other contexts is likely to require additional coordination. Ultimately, however, these shifts toward supporting roles will enable mentoring programs to focus their resources on what they do best—recruiting, screening, training, and supervising volunteers to form productive alliances.

Taken together, the paraprofessional model of mentoring will require shifts in a basic service model that has remained essentially unchanged since the early 1900s. Yet decades of mentoring program investment and research have failed to move the needle on youth outcomes and, despite being generally less effective than targeted evidence-based approaches, nonspecific models remain dominant. Many mentoring program staff and volunteers feel overwhelmed and ill-equipped to work with the increasingly vulnerable youth that programs are being asked to serve. These struggles are persisting against a background of the COVID-19 pandemic, record inequality, imbalanced opportunities, climbing rates of youth distress, a fiercely competitive funding landscape, and a consensus in the broader helping fields that decisions should be informed by the best available research and economic evidence. The mentoring programs that will thrive in the future will be those that can be delivered in ways that ensure fidelity and easy, straightforward use and can demonstrate a clear return on investment over the relatively short term. These criteria have led to improved effectiveness and cost-effectiveness across medicine and mental health care, and the same will be true for mentoring.

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