A Peer-Support Mental Health Response Training for Adolescents

During a health crisis, adolescents are often more likely to turn to their peers for help than they are to an adult. Consequently, training adolescents to respond to mental health crises could be a strategy for supporting this population.

In a pilot trial, we tested the short-term efficacy of a peer support training program for UK adolescents. We explored whether adolescent peer supporters who received training reported increased self-confidence, social connectedness and 'agency capabilities to make a difference to their peers.

The training content consists of bite-size modules on the four active ingredients of youth mental well-being (Mattering, selfhood, compassion and mindfulness) delivered through workshops and simulation activities. Using a pre-post with control evaluation design, the primary outcome assessed is adolescents' fidelity in responding to real cases of peer disclosure in which they indicate Mattering, selfhood, compassion and mindfulness.

The training increased support-giving skills, frequency of providing support, and peer connectedness among adolescent peer supporters who had received training, compared to controls, up to 4 weeks post-randomization. Adolescents' self-reported motivation to provide support also increased after training. The results of this study add to existing research on the potential benefits of peer support training.

Adolescents are more likely to turn to their peers for help during a crisis than adults. This is partly because adolescents are less trusting of adults but also because their inexperience means they may not have the resources to cope on their own8,10.

Training for peer supporters can increase young people's ability to support others during a mental health crisis. Still, the impact on their well-being and dimensions of agency (self-efficacy and civic engagement) remains unclear. This study explored the short-term outcomes of a digital peer support training program for adolescents and found that it increased motivation to provide peer support, frequency of providing support, compassion towards peers, and connectedness to peers relative to a wait-list control group.

In addition, open-ended questions assessed participants' perceived impact of training, use of peer skills and intentions to use peer skills in the future. These findings are encouraging and show further benefits of peer support training for adolescents' mental health, well-being and dimensions of the agency.

Adolescents have less independence than adults and often lack the confidence to seek mental health care without parental consent. This is especially true for lesbian, gay, bisexual, transgender, queer, intersex and asexual (LGBTQIA+) adolescents8,10.

It is, therefore, important to develop peer support training that works with adolescents in crisis. The study aimed to assess whether this would be possible with online peer support training.

Using the Peer-Support Mental Health Response Training for Adolescents, adolescents were trained to respond to their peers in an emergency and connect them with resources that could help. This included teaching them to check for risk of harm, listen non-judgmentally, offer encouragement and give resources for professional support.

In the 12 intervention schools, a convenience sample of peer supporters was invited to attend feedback meetings with the research team approximately 6 and 18 months after the training. These focus groups explored their experiences of the service and identified barriers to implementing it.

Peer support is a form of help-giving between peers that promotes values-led relationships. It can heighten young people's 'agency capabilities, i.e., the ability to pursue valued outcomes such as making a difference in the community. However, few studies have assessed peer-support training in isolation to evaluate whether this type of training can bring benefits to adolescents' mental health and well-being.

To address this gap, we designed a peer-support mental health response training for adolescents that teaches them to respond to a peer if they experience a mental health crisis. We evaluated the impact of this training on adolescents' self-reported feelings of preparedness to deal with a mental health crisis if they were faced with one.

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