Feasibility and Acceptability of an Open Trial Peer-Supported Mental Health Program for High School Youth

For many youths, schools are often the primary site to receive mental health care given these services are typically free, do not require travel to a clinic, and are embedded within the environment where youth spend most of their day. Growing evidence indicates that peer-supported treatments can provide unique benefits to youth regarding treatment engagement, reduction of stigma around mental health, and improving treatment outcomes. This study evaluated and open trial of a school-based intervention addressing internalizing symptoms for high school students with a peer-to-peer component to address treatment fidelity and increase social connectedness. Students (n= 9) participated in research evaluation of the intervention and provided both clinical and qualitative data and staff members (n=7) participated in qualitative interviews to evaluate the feasibility and acceptability of the intervention. The study design includes both qualitative and quantitative data and included use of reliable change indices, rapid matrix analysis, the expanded framework for reporting adaptations, and evaluation of intervention engagement and implementation metrics (e.g., attendance, homework completion). Results indicated that the intervention was favorable to students and staff and the intervention was not iatrogenic, though significant clinical gains among a majority of youth was not observed. Adaptations in this study were made collaboratively at each stage of implementation and staff found that the intervention was a good fit for the school, and that research staff felt engaged in the school. Students were engaged in the intervention and while they shared that social anxiety and stigma were barriers in the intervention, they noted growing readiness for and an appreciation of the peer support role. A conceptual model regarding peer-support role development and longitudinal youth engagement in school-based interventions was also developed integrating results and research literature that may be tested in the future.