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Method: Seventy-five percent of participants enrolled in Cornerstone (n=20) were matched with a mentor. Relationships lasted between one and nine-months. Contact via text, phone and in-person meetings varied from daily to monthly. Mentor training lasted four days, and supervision was held monthly. Within a Hybrid Type 2 trial, investigators developed an interview protocol on feasibility and implementation strategy domains (Powell et al., 2012). Example items included: 1) what worked best (worst) about supervision?; and 2) did providers find the model acceptable for serving their clients? Face-to-face interviews were conducted with stakeholders (n=10) and multi-disciplinary experts (n=20) on programmatic aspects of the CMP. Concurrently, analysts coded case summaries written by mentors (n=20). Multiple coders analyzed the data using constant comparison. Iterative discussion(s) occurred over six months until saturation was met.
Results: Feasibility data suggest that mentoring can be implemented within mental health settings and that mentors report mutually satisfactory relationships between mentors and mentees. Data also suggest training protocols need adaptation. Data suggest promising outcomes for youth participating in the overall Cornerstone model, with staff reporting improved engagement, social relationships (clients became more social, less isolated, more connected to family, peers and providers), and improved mental health (coping, anxiety) and functional outcomes (high school graduation, employment). Implementation data emerged on the policy context (the costing conundrum), with respondents discussing value-based payment, and the importance of tracking non-billable tasks of mentors. Data also pointed to important areas of planning, integration of mentors within the clinic, regular team check-ins, and the increased use of technology by mentors. Data emerged on educating mentors through training and supervision, such as the expressed need for more training, training specifically on relationship skills and overall the need for increased supervision. Finally, data on restructuring staff communication was mixed with divergent statements regarding cross-discipline communication. Some staff reported it was “seamless” and others suggested communication was “unclear” and “inconsistent” between clinicians and mentors.
Discussion: Mentoring in mental health settings is feasible, acceptable, and has promise. Overall, this study demonstrated that mentoring can be embedded in multi-component interventions for youth to enhance client retention and improve outcomes. When implementing mentorship programs, data suggested that the role of mentors in the agency needs to be more specified and clarified for clinic staff. Data suggest that settings bolster the structure, and amount of training and supervision for mentors. Also, the study provides critical data on aspects of the program that can be refined for further efficacy trials of the CMP.