Untapped potential: New paper argues for deploying mentors to address youth mental health crisis

By Jean Rhodes

Big Picture

The demand for child mental health services vastly exceeds the supply. Fewer than half of young people who need services actually receive treatment, and this gap is expected to widen as rates of mental health problems continue to climb. Mentors can help, particularly if the field more fully embraces what Hart et al (2022) recently described as “the untapped potential” of addressing mental health care.  The basic contours of formal mentoring relationships follow those of professional helping relationships (e.g., often meeting once a week in mostly one-on-one relationships), and many youth mentees present acute symptoms of anxiety; depression; and social, emotional, and behavioral struggles that impede their academic performance and other long-term goals. Indeed, mental health concerns are often what prompt parent and teacher referrals, and mentoring programs are particularly successful in moving the needle on depression in vulnerable youth. Consequently mentoring programs are currently working with youth who are more than twice as likely than youth overall to be suffering from a mental health problem such as depression or anxiety, and three times more likely to have ADHD.[i]

Single-session interventions. One way to do this, according to a Hart et al. (2022)  (excerpted below), is to train mentors to deliver single session interventions (SSI’s), increasing the value and acceptability of SSIs, and extending the reach of mental health care. There is a need to expand youth access to mental healthcare in ways that are flexible across multiple settings, affordable, and rapidly scalable, and SSI’s fit that bill.  As they note, single-session interventions (SSI) for youth with psychiatric problems can yield moderate effect sizes of 0.32, which are slightly lower than multi-session psychotherapy (.46) but certainly larger than those generally found in long-term mentoring interventions (around .21). The fact is that youth who access traditional, multisession treatments attend an average of less than 4 sessions and that the modal number of sessions completed before termination is just one (Hoyt et al., 2018). More generally, the article makes a great case shifting mentors in mental health care.

The many advantages to tapping into mentors for mental health support

Excerpted from the article (with added bolded headers) Hart, M. J. , Sun, J. , McQuillin, S., & Schleider, J. (2022). Expanding the research of psychological services for youth: Untaped potential of mentor-delivered single session interventions. Journal of Community Psychology.
The authors argue that, “enabling [formal] mentors to act as psychosocial health service providers in more earnest roles, and capitalizing on their existing presence within community settings, holds many advantages.

  1. Reduced stigma: Mentors may decrease some of the stigma associated with treatment-seeking, a barrier often noted by teens (Gulliver et al., 2010). Bruce and Bridgeland (2014) found that more than 50% of youth report wanting a mentor and mentoring practices and programs are often found acceptable (Owen et al., 2018), suggesting that mentor-delivered interventions would have a high level of acceptability on individual and community levels. [Also, increased availability–there are more than 25X more formal mentors than trained clinicians].
  2. Similar backgrounds: Further, nearly 50% of mentors are non-White (Garringer et al., 2017) whereas only 16% of licensed psychologists identify as ethnic or racial minorities (APA, 2015). This difference is notable, as racial congruence between clients and therapists predicts greater retention in youth psychotherapy (Wintersteen et al., 2005), suggesting that adolescents may prefer to work with mentors with backgrounds like their own even when professional services are available. Because minoritized youths with elevated psychological distress are less likely to access professional mental healthcare than their nonminoritized peers (Garland et al., 2005), these types of cultural and demographic considerations are vital to increasing the accessibility and acceptability of supports.
  3. Community integration: In addition to these benefits, mentors’ established presence in community settings may foster communication and coordination among caring adults who interface with youths. For example, a school-based mentor may be able to gather ongoing information from administrators, teachers, and support staff on site, and consult with guardians via phone to collaboratively share concerns and set relevant goals with students. This mentor could also then access additional data—such as attendance, disciplinary records, and grades—to accurately track progress toward that goal. Although mentors’ roles differ from those of formal advocates or case managers, there are similarities among their practices (e.g., noticing concerns, tracking progress, and working toward goals). More than 40% of parents of youth with mental health conditions indicate a desire for care coordination (Brown et al., 2014), and care coordination has been linked to greater mental healthcare access, particularly among students with disabilities (Witt et al., 2003). In sum, mental health, behavioral, and academic concerns often co-occur and reinforce one another (DeSocio & Hootman, 2004), and capitalizing on pre-existing avenues (e.g., mentoring programs) to improve the coordination of youth mental health supports can aid the identification and rapid deployment of services for the diverse, often-shifting issues that youth face.
  4. Helpful in promoting mental health: Mentoring relationships may also help address youth mental health concerns. Youth with mentors have reported fewer depression and social anxiety symptoms than their nonmentored peers (Dewit et al., 2016), and an evaluation of five US mentoring agencies over a period of 13 months showed that depressive symptom reduction emerged as the strongest and most consistent benefit of youth mentoring (Herrera et al., 2013). These findings are especially notable as youth referred to mentoring programs are more than twice as likely as their same-aged peers to meet the criteria for a mental health concern, and particularly in low-resource environments, parents may first seek mental health services for their children via mentoring programs, (i.e., parents of mentored youth might embrace SSI delivery as an opportunity to meet the needs of youth; Herrera et al., 2013; S. D. McQuillin et al., 2021; Sourk et al., 2019). These patterns lend support for exploring the use of mentors in intentional, targeted efforts to reduce youth psychosocial suffering, such as through coupling them with SSIs….
Youth mental healthcare is in increasingly high demand, due in part to the ongoing COVID-19 pandemic, and traditional providers and service models do not have the capacity to aid all those in need. At the same time, mentoring programs are as popular and prevalent as ever, with the practice of youth mentoring even becoming “professionalized” in some cases (i.e., working as a youth mentor can be a full-time, paid job; Eddy et al., 2017). While mentoring programs and relationships are already linked to a host of beneficial outcomes for youth, an expansion and reconceptualization of the field to this degree provides an opportunity to query and reexamine the mechanisms at play in youth mentoring relationships.”