Youth Mental Health Corps: A Not-So-New, Misguided Idea
By Carolyn D. Gorman, M.S., Paulson Policy Analyst at Manhattan Institute.
A new program, Youth Mental Health Corps, is rolling out in a number of states across the country this year. The program will give hundreds of young people ages 18-24 training to provide youth mental-health support in schools and communities, and it seeks to “increase workforce opportunities” for young adults with lived experience. While the Youth Mental Health Corps has similar good intentions to that of AmeriCorps, from which it takes its name, the program may do more harm than good. Youth Mental Health Corps repackages existing trainings by giving participants a certification for their choice of Mental Health First Aid, Peer Support, or Community Health Work. But none of these trainings have been effective at improving meaningful outcomes for youth with mental illnesses.
Mental Health First Aid teaches “how to identify, understand, and respond to signs of mental illnesses.” Research finds that trainees feel better for taking the class, but multiple gold-standard evaluations show it does not increase treatment access nor improve quality of support from trainees. Studies find that even when trainees feel more confident they can help, they don’t provide help more often. When they do, they don’t use what they’ve learned. One study found that college students in dorms with trained resident advisors were less likely to receive mental-health support — even when students had a baseline need for treatment. Outcomes for Mental Health First Aid have been so lackluster that it’s been rebranded “Mental Health Awareness Training” in recent years.
Peer support has also been extensively researched, but evidence is weak that those with lived experience provide better support than others — say, doctors. In a review of 18 studies with nearly 5,600 participants, researchers concluded that, despite wide promotion, “there is little evidence from current trials about the effects of peer support for people with severe mental illness.” Peer support may, however, misdirect public funds from more efficacious services, and according to the Centers for Medicare and Medicaid Services, peer support was associated with much higher total Medicaid costs. A separate concern: depression, self-harm, and suicide may be socially contagious. More research on the potential harm of peer support, particularly among youth, is warranted to be sure it is a responsible approach. Recent increase in tics across young girls, possibly induced by awareness videos on TikTok, suggest potential unintended consequences.
Providing Community Health Worker certifications also raises concerns. While mental health workforce shortages are certainly a challenge to address, adding minimally trained workers to the mix could increase risk that services provided are inadequate, or even harmful. Already, youth receiving mental-health treatment frequently get services that aren’t evidence-based or that don’t meet established guidelines. “We often hear that there are too few therapists,” says Dr. Mark L. Ruffalo, a psychotherapist practicing in Florida, “but this is not true. We likely have too many poorly trained therapists who focus on the ‘worried well’ and too few trained to treat the severe problems that contribute to the most suffering.” What’s more, the Community Health Worker certification is not a required credential in most states. So, for someone interested in a career in mental health, participating in Youth Mental Health Corps means trading time that could have been spent on a different credential that does have value.
Youth Mental Health Corps is currently funded by both philanthropic and public dollars, according to reporting by Axios; programs in California, Iowa, Maryland, New York, and Virginia are expected to start this year. But before widespread implementation, states and private funders should understand the likely limited impact. A better approach would be to fund direct services for youth with a current need for mental-health treatment — about 80 percent of whom do not get it.