Differential Protective Influence of Mentorship on the Long-Term Mental Health of Sexual Minority Young Adults with Depression Who Do and Do Not Receive Counseling

Background and Purpose: Sexual minority young adults (SMYAs) are disproportionately affected by depression compared to their heterosexual peers. Elevated rates of depression necessitate access to effective treatment. Yet, SMYAs report significant barriers to care, leading to unmet mental health (MH) needs. Given these barriers, it is important to examine alternative sources of care that may improve SMYAs’ wellness. The current study examined if having a mentor weakened the influence of depression on later life psychological distress and depression among SMYAs. In exploring how these relationships function under the condition of treatment receipt, this study primarily aimed to determine if mentors were a complementary resource for depressed SMYAs who receive counseling or a compensatory resource for depressed SMYAs who do not receive counseling.

Methods:

Data and sample: This study used unrestricted data from Waves III and IV of the National Longitudinal Study of Adolescent to Adult Health, a longitudinal study of a nationally representative sample of U.S. adolescents (aged 18-24 at Wave III). To be included in the analytic sample, respondents identified as a sexual minority and met criteria for depression at Wave III.

Measures: The CES-D and Cohen’s Perceived Stress scale measured depression and stress, respectively. Respondents were asked if an adult has made a positive difference in their life and characteristics of this relationship (e.g., type of mentorship support, closeness to mentor). Counseling receipt was a binary indicator of having received counseling. Sociodemographic covariates included race/ethnicity, sex, and sexual identity.

Analyses: SEM was used to evaluate hypothesized relationships and pursue two distinct types of moderation analyses: 1) mentorship as a protective influence on the relationship between Wave III depression and Wave IV perceived stress and depression, and; 2) SEM-based multiple group comparisons to test path differences as a function of counseling receipt.

Results: The sample included 473 depressed SMYAs. Most respondents were White (n=256; 45.9%), female (n=383; 81%), and had a mentor (n=385; 81.4%). Across the sample, the mean CES-D score at Wave III was 1.30 (SD=0.39). Although all respondents in the sample had depression, 79% (n=375) did not access psychological counseling. Results of the multiple group analysis showed that for the depressed SMYAs who received counseling, mentorship had a protective influence against the deleterious effects of Wave III depression on Wave IV stress (b=0.86, p≤0.001). Similar buffering effects of having a mentor were not observed among depressed SMYAs without counseling receipt.

Conclusion and Implications: This study found mentorship served as a supplement to psychological counseling—rather than a compensatory resource—as over time depressed SMYAs who received counseling and mentorship support had better psychological distress and depression outcomes than: 1) depressed SMYAs without counseling and without a mentor; 2) depressed SMYAs without counseling and with a mentor, and; 3) depressed SMYAs with counseling and without a mentor. As mentorship is an accessible resource that is readily used by SMYAs, interventions might consider harnessing the positive impact of mentors by formally incorporating them into MH programming for depressed SMYAs to bolster treatment acceptability and improve long-term MH outcomes.