Persuasion & healing: Why youth mentoring programs should prioritize mental health

“The pieces I am, she gather them and gave them back to me in all the right order.”

Toni Morrison, Beloved.

by Jean Rhodes

Although youth mentoring programs should continue to target the full range of issues (e.g.., academics, college access, job skills), mental health and wellness are particularly important priorities. The basic contours of formal mentoring relationships follow those of professional helping relationships (e.g., meeting once a week in mostly one-on-one relationships), and many youth mentees present with acute symptoms of anxiety, depression, and social, emotional, and behavioral struggles that impede their academic performance and other upstream goals. What’s more, concerns about mental health are often what prompt parent and teacher referrals, and mentoring programs appear to be particularly successful in moving the needle on depression in vulnerable youth. 

The fact is that volunteer mentoring relationships and therapeutic relationships share much in common. For example, they are often situated somewhat outside the youth’s network of family, friends, and community, and often involve weekly “sessions.” Likewise, they are characterized by inherent power differentials and a focus on only one member’s improvement. Mentoring also adheres to the same rituals as therapeutic relationships. In their classic book Persuasion & Healing, psychiatrists Jerome and Julia Frank noted that all helping relationships have four factors in common: a “confiding relationship with a helper,” who “genuinely cares about their welfare, and has no ulterior motives;” a “healing setting,” or context that is somehow set apart by time or location; a “rationale, conceptual scheme, or myth that provides a plausible explanation,” for whatever difficulties led the person to seek out a helping relationship; and, finally, a ritual or intervention that both parties believe will be an effective means of restoring health. These “nonspecific” factors create positive expectations that can help bring about change. Since formal mentoring satisfies these conditions, it occupies a place in the pantheon of healing interventions. And, although rarely acknowledged and not particularly systematic, formal mentors frequently draw on a wide array of established therapeutic techniques. For example, as mentors encourage their mentees to think and act in more adaptive ways, they often employ principles of cognitive behavioral therapy (CBT), which helps young people develop the skills needed to effectively address many of the most common psychological problems. To the extent that programs begin to think of volunteers as paraprofessional helpers and begin to harness all that is relevant from treatment and prevention science, they will be better positioned to deliver effective care. In doing so, volunteer mentors will help bridge the enormous (and growing) gap between those youth who need help and those who actually get it.  

Moreover, although funders may prioritize other issues, such as school success, it is important to note that mental health struggles often precede academic, social, and career difficulties. When youth learn and develop behavioral and emotional regulation skills (e.g., self- and social- awareness, decision making, self-management, relationship skills) they are better positioned to keep impulses in check and focus on schoolwork. Such skills are vital to youth who have been exposed to toxic stress. Exposure to violence and stressors often trigger automatic fight-or-flight neural connections (or circuits) and these impulses are in opposition to the more intentional responses that are needed to ignore distractions, pay attention, and learn. 

Therefore, it is time to more directly align youth mentoring with the best practices of mental health and wellness. Decades of research have shown that, with the right training and support, paraprofessionalsnon-expert paid or volunteer care providerscan deliver interventions just as effectively as professionalsand in some cases, even more so and in ways that will help narrow the unacceptably high service gaps. Indeed, only about 20 to 30% of children and adolescents who need mental health and related care receive such services, and these rates are even lower in ethnic minority populations, many of which are exposed to even higher levels of risk. Even if every professional worked around the clock, there would simply never be enough of them to meet the needs of today’s youth. Most professional mental health workers earn graduate degrees and professional licenses that require years and years of study and certification and their specialized services are in high demand. Youth-serving mental health facilities are often at capacity and have long waiting lists, and annual rates of staff turnover in the child- and adolescent-serving mental health workforce exceed 50%. These shortages, as well both attitudinal issues (e.g., concerns about stigma, cultural insensitivity, low treatment effectiveness) and structural issues (e.g., cost, transportation, time, access) have created overwhelming barriers for many parents who are seeking professional care for their children. In some countries more than 90% of people with the most common mental health struggles (i.e., depression, anxiety, post-traumatic stress disorders) have no access to empirically-supported psychological treatment. Yet, left untreated, many of the early social, emotional, behavioral, and academic struggles that emerge in childhood and adolescence grow increasingly more complicated and difficult to resolve. Mentors have a valuable role to play in delivering or supporting the delivery of evidence-based mental health care.