Peer Programs: A Solution for Youth by Youth

Samskruthi - California

Mental health found a concrete role in my life last summer when I received a text from my best friend saying that she had one leg out her window the night before and was planning to commit suicide. Panicked, I contacted a suicide hotline, and fortunately, with the help of the crisis service, she chose life. However, this prompted me to ask why it took such a situation of crisis for her to get the help she needed. After the incident, when I encouraged her to get professional help, there was always a list of barriers in her way, from stigma to a lack of family support. Her story is frighteningly normal: Though 50% of mental illnesses appear by the age of 14, the average lag between onset and getting help is eight to ten years.¹ Due to issues such as stigma, lack of accessibility, and lack of inclusivity in mental health care systems, adolescents often do not receive the help they need until there is a crisis. The most effective way to bring help to youth is through peer programs, which reduce stigma, increase mental health literacy, and encourage students to get the most effective and comfortable help available for them.

A large barrier facing youth who struggle with mental health is stigma due to a lack of mental health education. Mental health is often viewed as taboo, resulting in the toxic mindset that mental illness is weak and abnormal. Stigma makes it difficult for youth to understand and cope with their mental health issues, while also making them feel alone in their struggle. This loneliness is furthered by the fact that youth are often unable to discuss their mental health with peers or with parents. Data from the Born This Way Foundation affirms that 49% of youth rarely or never talk about their mental health, despite 88% of youth acknowledging mental health as a priority.² Adding to this suffocating burden, teens with mental health issues are forced to reach out for help on their own with little guidance. According to the Born This Way Foundation, 47% of youth cite not knowing where to go for help as their key barrier to receiving mental health services.² Stigma at all steps on the journey to help, from difficulty recognizing mental health issues to the lack of guidance in seeking services, bars youth from getting help.

However, even when youth make the decision to seek help, they face a new set of difficulties in mental health care systems, which are often inaccessible. For example, 42% of youth cite their inability to afford mental health care as their main barrier to getting help.² Mental health services are often too expensive for youth to pay, excluding low-income youth as well as youth whose parents or guardians are unwilling to support their decision. In addition, mental health care is often less accessible to youth of ethnic minorities. Of African American and Native American youth, 40% and 48% respectively reported that their communities rarely or never have access to youth mental health resources, as opposed to 28% of white youth.² This reflects the lack of cultural competency in youth mental health care systems, which leaves whole subsets of the population whose struggles are not understood. Another systemic issue is the focus on pathologization in mental health care systems. This approach is harmful because it does not account for the environmental and social factors that contribute to mental health, which may not necessarily be tied to a diagnosable illness. In addition, since mental health services are most often found in clinical settings that focus on treatment rather than building trust and comfort, youth who are surrounded by stigma often feel uncomfortable seeking out this kind of help. Current mental health services fail to account for the unique challenges and diverse experiences that contribute to youth mental health. The challenge for mental health systems, therefore, is to reach youth in a more effective way that reaches past stigma to people of all experiences.

A solution is to invest in the implementation of peer programs in all school districts. Peer programs are groups of student leaders who are trained to increase mental health literacy and discussion. While they do not necessarily provide counseling themselves, peer programs are incredibly effective in reducing stigma and encouraging students to seek appropriate help. Youth in peer programs often initiate a variety of mental health projects within their schools that incorporate discussions and activities that encourage youth to understand and discuss mental health. This has proven effective in Michigan, where implementing a peer program saw a significant reduction in stigma and a significant increase in people willing to talk to their peers about mental health.³ In addition, since youth have an understanding of the unique challenges faced by their student body, they are able to create effective change. As peer leaders interact with others, they are able to support those struggling with mental health issues and guide them toward the best options for their treatment. This is facilitated both by the reduction of stigma and by the trustworthy environment created by peer leaders. With their diverse lived experiences, training, and knowledge of the school community, these youth could guide others to the most effective and comfortable service for them. This guidance is crucial, especially since youth often have to navigate the world of treatment on their own. In Michigan, youth in schools with peer programs reported a higher likelihood of seeking professional help and knowing where to go.³ Therefore, peer programs are a unique way to bring comfortable guidance and long-term reduction of stigma directly to youth communities.

Another facet of peer programs could be the development of support groups with peer leaders as facilitators who can guide the group to resources. Involving youth with a variety of identities and lived experiences in peer programs is crucial to maximizing success. Forming groups of youth with similar struggles ignites trust and a connection that makes students feel heard and more comfortable seeking help. In addition, they could help youth who do not have access to services due to a lack of familial support, since support groups would be held at school for no cost. They also serve as a vehicle for youth to talk about their mental health with people they trust, which removes the discomfort that often accompanies clinical services. This is especially useful in groups that often have less access to mental health services, such as Asian youth, African American youth, Native American youth, foster youth, and LGBTQ+ youth. In support groups, the peer leaders could also share the resources that would be best suited to their group based on personal experience and training, eliminating the barrier of youth not knowing where to go.

Peer programs are useful in breaking the stigma around mental health and encouraging youth to seek out help while involving youth voices and activism. As a youth, I represent my county in the California state Mental Health Oversight and Accountability Commission’s Youth Innovation Project Planning Committee, in which I work to plan innovation projects for youth mental health. At one of our meetings, we were asked what our ideal world would look like in terms of mental health. My mind immediately envisioned seeing peer programs throughout the world, transforming schools and youth communities into places rid of stigma and filled with support. My hope is for a world in which youth like my friend who struggled in silence could finally be heard and supported on their path to recovery.

References

1. National Alliance on Mental Illness. "Mental Health Facts: Children & Teens." National Alliance on Mental Illness, 21 Sept. 2016. Infographic.
2. Born This Way Foundation. Youth Mental Health in America: Understanding Resource Availability and Resources." SlideShare, 21 Mar. 2019.
3. Parikh, Sagar V., et al. "The Michigan Peer-to-Peer Depression Awareness Program: School-Based Prevention to Address Depression among Teens." Psychiatry Online, 1 Mar. 2018, doi:10.1176/appi.ps.201700101.

NIH recognizes these talented essay winners for their thoughtfulness and creativity in addressing youth mental health. These essays are written in the students' own words, are unedited, and do not necessarily represent the views of NIH, HHS, or the federal government.

Page updated August 30, 2022